Sex Change Operations: All You Ever Wanted To Know About Transsexuals And Surgeries For Change Of Sex

Hospitals are reportedly undergoing around 100 sex change operations in a year. The term transsexual is referred to a person who has misaligned gender and sex. Around puberty, a transsexual is sure that s/he is not born with the same sex as his gender. In this article, we talk about sex change operations, what are the basic requirements for undergoing a sex change operation, and much more. We get in touch with surgeon Dr Richie Gupta, who begins with explaining about transsexuals and why they feel the need of sex change operations or sex reassignment surgery. "Every person has two different identities, one is sex and the other is gender. Sex of a person is decided at the time of birth. But gender is related to the mind. Gender is a personal and inbuilt sense of being female or male. In usual cases, sex and gender are in alignment. But in case of transsexuals, the sex and gender are not in alignment," says Dr Richie.

Transsexual is a person who has misaligned gender and sex
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Around 3 to 4 years of age, a transsexual begins to feel in the wrong body. It leads to experiencing conflict with the society, including parents and social circle, along with conflicts with the self. "This leads to a phenomenon known as gender dysphoria," says Dr Richie. Gender dysphoria is a condition in which a person feels his or her emotional and psychological identity to be opposite to biological sex.

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In certain individuals, gender dysphoria may become so severe that they may attempt suicide or get into depression. They even feel the need of getting rid of their sexual organs. This is where sex reassignment surgeries become significant. "We do around 100 to 150 cases of sex change operations every year," he says.

Gender dysphoria may make transsexuals get into depression
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Sex change operations

Diagnosis of transsexuals is the first step undertaken for sex change operations. People who are willing to get a sex reassignment surgery are made to meet mental health professionals. According to the criteria set by World Professional Association for Transgender Health, two different psychiatrists should see the person and certify that the patient is transsexual. "A person cannot be classified as a transsexual on the basis of a feeling merely," says Dr Richie.

Psychiatrists work towards ruling out the possibility of other mental health disorders such as psychosis or schizophrenia. The patient should not be intersexual or have any other congenital defect. S/he has to be transsexual male or female with no underlying health conditions. "Most people realize that they are transsexuals and need to get a sex change operation around stage two or three of puberty - which is around ages 12 to 13 years. Diagnosis for sex change operations is usually done after this stage."

Sex change operations enable transsexuals to have sexual intercourse with the opposite sex
Photo Credit: iStock

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Once the mental health professional certifies that the patient is transsexual, he then refers the patient to surgeons.

Another essential requirement for diagnosis for sex change operation is based on the real life experience of the person who is willing to get sex changed. "A male person who wants to get his changed sex should have lived as a female in the society for at least 2 years. He needs to address himself as female to his family, in his school, college or workplace," Dr Richie explains.

After meeting these requirements, the patient qualifies for a sex change operation or a hormone therapy.

Hormone therapy for sex change operations

Dr Richie explains that hormone therapy facilitates the desired sexual role in the person. Under hormone therapy, male hormones are induced in a female transsexual and vice versa. This makes the female transsexual have a deeper voice, growth of beard or moustache, a change in muscular development and fat distribution, etc.

"After this hormone therapy, surgery or sex change operation is done," he says.

Surgery in sex change operations

In a surgery which involves male to female change of sex, one surgery is done. In this surgery, the male genital organs are removed and construction of female genital organs is done.

"Breast enlargement is the second stage of sex change operation. Breast enlargement may or may not be required after hormone therapy. Most people get enlarged breasts after hormone therapy. Additional surgery for breast enlargement is done only if the patient asks for it," explains Dr Richie.

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Three surgeries are required in female to male sex change operation. First surgery is done for reduction of breasts, the second one includes removal of female internal organs, and the third surgery involves reconstruction of make organs.

All these surgeries are done in 3 months. There are gaps in between each surgery to allow the patient to recover in a healthy way.

Side effects of sex change operations

Dr Richie mentions that side effects of sex change operations are the same as any other surgery. There are risks of bleeding and infections - as is the case with any other major surgery. There is no side effect which is specific to the nature of sex change operation.

Time for recovery after sex change operation

"Recovery is faster after the first and second surgery as they are not that major surgeries. Reconstruction of penis is a major surgery, which requires at least a month's time for recovery," he says.

After successful surgeries, the patients become capable of having sexual intercourse with the opposite sex. However, they cannot become biological parents. "Lack of testes and ovaries make transsexuals incapable of becoming biological parents. But they are provided the provision of preserving their ovum or sperm before undergoing surgeries. They can thus become half-biological parents with the help of fertility methods like test tube baby etc."

Sex change operations don't pose risk to life

Dr Richie assures that sex change operations are relatively safe and don't pose risk to life. He says that surgery is similar to a gallbladder or kidney surgery and is not as dangerous as a heart surgery, for instance.

"There is no grave risk to life in sex change operations," he assures.

(Dr Richie Gupta is Director and Head, Department of Plastic, Cosmetic and Reconstructive Surgery, Fortis, Shalimar Bagh)