A 101 guide to get you started.
Not everyone will want or be able to have any or all of these procedures done.
Part 1. Genital surgery
A. Orchidectomy: the removal of the testicles, a surgery that can be done on its own, or as part of another form of genital surgery. It is the procedure with the least amount of risk, and least amount of recovery time. As with any procedure, there are risks including but not limited to chronic pain and infection. If done prior, it can complicate some forms of vaginoplasty, but it will not prevent you from being able to get a vaginoplasty later should you so desire.
B. Vaginoplasty: the construction of a neo-vagina and vulva. Prep includes getting permanent hair removal via laser hair removal or electrolysis from the penis and scrotal sac. Each surgeon will have their own guidelines for this. And each surgeon will have a slightly different proprietary technique.All of these procedures have risks including but not limited to: chronic pain, infection, and death. Typically you will need at least 2 letters from different licensed psychologists and another from your doctor to be able to receive a vaginoplasty. Following are the most common procedures
- Penile inversion: The penis is disassembled and parts are repurposed for the clitoris and vaginal lining. The urethra is shortened, and the scrotal tissue is used to form the labia. This is the more common technique used in North America and Europe
- Scrotal inversion: Sometimes cannot be done after having an orchidectomy prior due to problems with skin elasticity. In this procedure, the scrotal sac is used to create the vaginal lining and parts of the penile tissue are used for the clitoris and the labia. This is the most common technique used in Thailand.
- Shallow canal vaginoplasty: Harder to find, and how it works depends on the surgeon. This is useful if you have certain health problems that won’t allow you to have other forms of vaginoplasty or if you aren’t interested in penetration. Healing is easier and quicker than other forms of vaginoplasty. More commonly available in thailand, but I believe Dr. Marci Bowers performs this technique as well.
Other non-standard genital surgeries are available but extremely hard to find, and usually are more expensive as well. Also they entail more gatekeeping.
Part 2: Breast Augmentation.
Also known as Mammary augmentation. Not recommended for people who haven’t been on hormones for at least 4 years. Your breasts will still be growing in that time, and that can severely mess up the results. Many types of implants and techniques are available, so consult the surgeon you will be working with. The three main materials used for augmentation follow.
- Saline: one of the safer materials. If your implants pop, it will be absorbed by the body.
- Silicone: much more dangerous but can create a more “realistic” feeling breast.
- Multiple types of silicone implants are used
- Fat transfer: Liposuction is used to take fat from another part of the body which is then implanted in the breast. Creates a natural feel, but can only be used for small size increases.
Part 3: Other procedures
A. Voice feminization surgery: Raises the pitch of your voice. Voice training is generally more effective, and doesn’t carry the risk of complete vocal loss. Vocal feminization surgery alone will not change the way your voice is perceived. Over half the women I’ve talked to who have had the procedure have regretted getting it done.
B. Tracheal shave: Reduces the appearance of the adam’s apple. Sometimes performed as part of facial feminization surgery. Voice needs to rest for 3 weeks after the procedure.
C.Facial Feminization Surgery: A group of surgeries performed together to increase the femininity of the face. Can include but not limited to
- Rhinoplasty: commonly referred to as a nose job
- Forehead contouring: removal of part of the bone from the head, eyebrow lift, and a scalp advancement
- Cheek augmentation: to create fuller cheeks. Multiple techniques are used.
- Mandible contouring and chin surgery: to create a more feminine jawline.
Part 4: sources.
all the various trans women I’ve known over the years