Becoming a Woman through Surgical Means

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Becoming a Woman through Surgical Means

An essay by Jadus Knight

"Transsexualism is not a modern discovery." According to Vaginoplasty (2000), Transsexualism has existed in society since the Greek and Roman days. Transsexualism is a form of Gender Identity Disorder. According to the Gender Identity Disorder (2007), "Gender Identity Disorder or GID describes a condition between a person's physical or apparent (sex) and that person's self-identification" For example, an individual could be born as a male but believe he was not born into the right body. Sexual reassignment is generally the solution for many individuals. Gender reassignment includes Hormone Replacement Therapy, facial reconstruction, breast augmentation, and Sexual Reassignment surgery (SRS). Although Gender reassignment is highly beneficial to Transsexual patients, there are many different procedures to endure, which are accompanied by many risks. These risks include contracting Human Immuno- Deficiency Virus (HIV), blood clotting, implant rejection, and other serious infections.

With the use of certain hormones and hormone blockers, a natural born male can become the hormonal equivalent of a female. After approximately six months of Hormone Replacement Therapy, the Male to Female Transsexuals will begin to notice body hair thinning, skin softening, and breast growth claims Hormone Replacement Therapy (2006). When a male wishes to become a woman, it is essential to have light to no facial hair. This helps a Transsexual woman or Trans-woman to pass as her desired gender.

Although, Hormone Replacement Therapy is a crucial step in the gender changing process, it is not always easy to attain legally according to Hormone Replacement Therapy (2000). Hormones are difficult to attain since many Endocrinologists often refuse Transsexual patients. Vaginoplasty (2000). Many Transgendered people are reduced to find alternative methods of attaining hormones. When buying hormones from under-ground doctors or "the street", there is an increased risk of contracting blood-borne pathogens like HIV. Transmission though infected needles is the easiest way for a Trans-woman to contract HIV and other diseases. "[The] findings indicate that 27.7% of MTFs [or Male to Female Transsexuals] tested positive for HIV infection" as of August 2007 according to Transgendered (2007) When numbers of infected individuals are this great, it is crucial to search for the safest way possible buy hormones.

Aside from risks of viruses, HRT involves risks of one very serious side effect. Many doctors prescribe their patients a type of hormone called Estradoil. This hormone contains a high risk of blood clots, especially in amounts that are used for Transwomen. Comparative Studies (1990). If left untreated, blood clotting can become deadly. Smoking cigarettes increases the risk of blood clotting. Patients and women on birth control should reduce or eliminate their tobacco use. Comparative Studies (1990).

Even though Hormone Replacement therapy can cause a biological male to develop breasts, Breast Augmentation is a very commonly used procedure. Breast Augmentation is a procedure in which silicone is injected to create the appearance of larger breasts. Breast Augmentation is a common procedure used on both natural-born and Transwomen.

Besides infection, there is a risk of implant rejection. Implant rejection is a most serious risk involved with breast augmentation according to Silicone Use: Illicit, Disfiguring, Dangerous (2003). Occasionally, the human body will reject foreign objects like silicone implants used in some cosmetic surgeries. This can result in a serious Silicone poisoning, which can become fatal. Individuals who have had breast implantation performed are strongly advised to receive regular checkups to ensure their body is accepting the implant correctly says Silicone Use: Illicit, Disfiguring, Dangerous (2003).

Another surgical procedure which is used for Transwomen is a Tracheal Shave or Chondrolaryngoplasty. This is used when the Adam's apple is overly noticeable. A tracheal shave is " a surgical procedure in which the thyroid cartilage is reduced in size by shaving down the cartilage through an incision in the throat, generally to aid Transwomen in achieving a passable female appearance" according to Dr. Anne Lawrence, Tracheal Shave(2004).

After all several years of Hormone Replacement Therapy and other cosmetic surgeries, the final procedure can be performed. This final surgery is called Sexual Reassignment Surgery or SRS. Sexual Reassignment Surgery should only be performed, "a patient must have a solid sense of [their] own gender identity [They should] not be at the beginning stages of questioning, exploring, [or] thinking things through. [They should have] enough mental stability to make an informed decision about their medical care. [It is important to have] enough coping skills and supports to withstand the typical stresses of SRS"Gender Identity Disorder (2006.) Serious depressions can occur if the patient is not read for this life altering procedure. Vaginoplasty (2000)

When the Transwoman is ready, there are two steps to Sexual Reassignment Surgery. The first procedure is called Vaginoplasty. Vaginoplasty is the procedure that essentially turns the penis into the vagina. Vaginoplasty (2000) states that it is often followed several months later by the Labiaplasty. The Labiaplasty refines the labia or external female genitalia.

During Vaginoplasty "the right spermatic cord is clamped and ligated. The primary incision is continued up the ventral side of the shaft of the penis. [Then] the anterior flap is developed from the skin of the penis. The urethra is dissected from the shaft. The corpora cavernosa are separated to assure a minimal stump. [After that] the anterior flap [is] perforated to position the urethral meatus. The skin flaps are sutured and placed in position in the vaginal cavity. [When that is completed], the preservation of the vaginal cavity is assured by the use of a suitable vaginal form." Vaginoplasty (2000). Finally the vagina is complete.

When a patient receives Labiaplasty, a frequently used procedure where labia and a clitoral hood are created. This is often performed a few months after the first part of the procedure. In some cases, labiaplasty is an elective procedure to improve appearance after a one-stage Vaginoplasty. Labiaplasty (2000).

Even after SRS there are many complications that range from minor to major. There are the minor complications which include infections, bleeding and loss of grafted skin. Vaginoplasty (2000). "The more serious complications include major infections or bleeding, and damage to the bladder [. There is a possibility of damage to the] prostate or major nerves during the dissection to form the vagina" according to Vaginoplasty (2000).

While undergoing this surgery, please note that the most severe complication is the formation of a vaginal-rectal fistula. This occurs when the doctor accidently cuts through the rectal wall during vaginal cavity dissection. As a result, excrement bypasses the anal stricture and exits through the vagina. This prevents proper healing. Vaginoplasty (2000). This process can be remedied through a long process of surgeries and the many months of wearing of a colostomy bag. Vaginoplasty (2000). Because of the embarrassment, the complication often goes untreated, leading to serious infections.

Between Hormone Replacement Therapy, a Tracheal Shave, and Sexual Reassignment Surgery, there are many risks of infection, rejection, and blood pathogen transmission. For a Transsexual, Gender Reassigning can be a very time-consuming and dangerous process. When considering this dangerous lifestyles change, please consider the risks of HIV, blood clotting, implant rejection, and other serious infection. Life and health are two things that should never be bargained with.

1. Gender Education and Advocacy Inc. (GEA) (Aug 2002). Breast Cancer in Transgendered and Transsexual Retrieved October 31, 2007, from
2. Gender Education and Advocacy Inc. (GEA) (August 22, 2003). Silicone Use: Illicit, Disfiguring, Dangerous. Retrieved October 31, 2007, from
3. (October 04, 2007) Electrology,
4. (October 04, 2007)Tracheal Shave,
5. Rutherford, George W., & Mandel Jeffrey S. (2006). AIDS and Behavior. Center for AIDS Prevention Studies, Retrieved October 2, 2007, from Springer collection Database.
6. Ballas, Paul. Gender Identity Disorder Retrieved September 28, 2007 from
7. Daly, Leisha, & Bonnar, John. (1990).Comparative studies of 30 micrograms of ethinyl estradiol combined with gestodene and desogestrel on blood coagulation, fibrinolysis, and platelets. American Journal of Obstetrics and Gynecology. Retrieved October 17, 2007 from Thomas Gale database.
8. (2001). Selected Estrogen Compounds Modify Risks of Vein Clotting. Women's Health Weekly. Retrieved from Thomas Gale on October 10, 2007.
9. (October 10, 2007) Blepharoplasty,
10. (November 24, 2007) Labiaplasty,
Used with permission by Judas Knight.