Maxi Gender Reassignment

The first ever data on gender reassignment surgeries in the United States shows demand is skyrocketing.

The American Society of Plastic Surgeons found a nearly 20 percent increase in vaginoplasties, phalloplasties, top surgery and contouring operations in just the first year of reporting.

In 2016, more than 3,200 surgeries were performed to help transgender patients feel more like themselves.

Surgeons in the field claim that figure is a conservative estimate - and would likely three times higher if all hospitals had a uniform way of documenting such surgeries.

And they believe celebrity transitions have been a driving force in this shift.

The first ever data on gender reassignment surgeries in the United States shows demand is growing. Gearah Goldstein is pictured here speaking with her plastic surgeon, Dr. Loren Schechter, about her gender confirmation surgery

Dr. Loren Schechter (pictured) says he's seen a dramatic increase in the number of transgender patients seeking surgery in the past few years. The American Society of Plastic Surgeons reported the number of gender confirmation surgeries for the first time, and found more than 3,200 procedures were performed in 2016

‘It’s only in the last couple of years that we’ve seen this dramatic increase in demand for procedures, it’s certainly a subject that’s more talked about,’ Dr Loren Schechter a board-certified plastic surgeon who’s been practicing gender-reassignment surgery for two decades, told Daily Mail Online.

‘It’s really the reason why the society is recognizing and collecting data.

WHAT IS FEMALE-MALE GENITAL SURGERY?

A phalloplasty is the construction of a penis using skin flaps from the thigh, groin or abdomen, and scrotum construction using the labia. Nerves can be connected to a reconstructed urethra, and the clitoris can be repositioned to sit at the base of the penis.

Sexual intercourse is possible post-surgery, sometimes using a prosthesis to create an erection, though some patients say that is not necessary. 

‘This is the first time that the ASPS is formally collecting the numbers and they’re probably a conservative estimate of procedures. I wouldn’t be surprised if it was double or triple.’

Increasingly, insurance companies are offering coverage for surgery for patients with gender dysphoria - a disconnect between how an individual feels and what their anatomic characteristics are.

Gender confirmation procedures can include everything from facial and body contouring to reassignment surgeries.

As Chicago-based Dr Schechter explains, ‘there is no one-size-fits all treatment’.

Gender transitions usually include more than just surgery.

Plastic surgeons often partner with other experts to provide comprehensive care, such as doctors who specialize in hormone therapy or urology and with mental health professionals who help patients through the emotional aspects of their transition.

Male to female genital surgery is called vaginoplasty; female to male genital surgery is called phalloplasty. There are various techniques and ways to perform each procedure.

Inspired by her own gender transition, Goldstein is now an advocate for transgender youth

She always felt a disconnect between her body and who she knew herself to be. With the help of a team of experts, she was able to make a transition that allows her to live her life as her true self

 But before 2014, Dr Schechter says, there were just six board-certified plastic surgeons trained in performing both male to female genital surgery and female to male.

‘Our surgical society is trying to not only meet the patient demand but also the surgeon demand,’ he explains.

‘MY EXPERIENCE OF REASSIGNMENT SURGERY’ 

Gearah Goldstein worked with Dr. Schechter throughout her transition.

Goldstein knew from a very early age that that her gender did not align with her body. Now, she says, she feels that she can live her life as the person she’s always been.

‘For transgender people, like myself, surgical options are a corrective treatment, not cosmetic,’ Gearah said.

‘The types of surgeries someone has is very personal and private, and you wouldn’t even know someone had surgery if you saw them walking down the street. It’s not about how we’re perceived by the public, but how we perceive ourselves.’

Goldstein is now an advocate for transgender youth. She says everyone has a unique story, but that her experiences help her understand what someone with gender dysphoria is feeling and how it can become an unbearable burden. She adds that gender confirmation, whatever that means for the individual, can be truly life-changing.

‘It has been a lifelong journey for me. Growing up, there wasn’t even a word for transgender. There were no role models or anyone to tell me that I could do something about this feeling of being disconnected from the body I was born with,’ said Gearah. ‘The reality that I lived through has allowed me to assure the next generation that there is nothing abnormal about what they’re feeling.’

‘Up until recently, there were only about half a dozen surgeons who offered both [vaginoplasties and phalloplasties].

‘The numbers are increasing, but one of the barriers is that there’s been no formal training program.

‘A few years ago it wasn’t very easy to find a hospital which would let them perform these procedures - be it for religious reasons or lack of insurance coverage, which makes it very expensive...’

Despite the lack of provisions, surgeons and research, Dr Schechter insists the landscape has changed for patients with gender dysmorphia.

‘Not that it’s easy to transition at this point, but it’s certainly different,’ he said.

‘Access to care has dramatically improved here in the states thanks to more insurance coverage - and societal attitudes have changed.

‘They don’t necessarily feel as isolated or alone as they might have done years ago.’

Members of the American Society of Plastic Surgeons undergo intense training to help these patients address the incongruity between their bodies and the gender they know themselves to be.

 ‘Surgical therapy is one component of the overall care of the individual,’ said Dr. Schechter. ‘It takes a team of experts across different disciplines working together to provide comprehensive care. I often partner with doctors who may prescribe treatments such as hormone therapy and mental health professionals who help patients through their transitions.’

Choosing a team of experts can be a difficult path to navigate. ASPS President Debra Johnson, MD, a board-certified plastic surgeon in Sacramento, California, says it is crucial to choose a surgeon who is certified by the American Board of Plastic Surgery to ensure the highest safety and training standards.

‘Board-certified plastic surgeons undergo rigorous training that is designed to not only provide the safest and best quality care, but also give patients a variety of options when it comes to gender affirming surgeries,’ said Dr. Johnson. ‘Our goal as plastic surgeons is to help get transgender patients to a place where they feel the most comfortable.’

Dr Johnson added: ‘I haven't been surprised by the increase in gender confirmation surgery. These potential surgical patients have always existed, but previously they had to pay out of pocket for their care, which some just could not afford. After new federal legislation was passed, health plans had to offer these surgeries as part of their coverage plans. So patients who couldn't previously afford surgery are finally able to gain access.’

WHAT IS MALE-FEMALE GENITAL SURGERY? 

A vaginoplasty is a far less costly and far more successful procedure than the female to male procedure.

In the surgery, the testicles and most of the penis are removed while the urethra is shortened.

The skin of the penis is then inverted and used to create a vagina.

In some procedures a neoclitoris is also created with that skin from the tip of the penile glans which allows for sensation.

The prostate meanwhile is not removed during the surgery, though it does shrink because of the hormones that are taken during the transition process.

After the surgery, patients spent three days in the hospital and must not do any strenuous activities for two weeks.

Initial recovery time is between four and six weeks for most patients, and after 12 weeks the patient is fully recovered.

Dilation must be performed by the patient multiple times a day for at least 12 weeks after the surgery for 15 minutes at a time, and at least once a week after that for the rest of their life.

Some doctors recommend daily dilation for life with the largest dilator or dildo the patient can comfortably fit into their new vagina.

At 12 weeks, the patient can have sex again and in most cases those who have had the surgery report that they are able to experience orgasms.

The procedure can cost anywhere from $5,000 to $100,000, with the average US surgery cost $20,000.

Bleeding, swelling and vaginal discharge are among the common side effects after surgery.

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Thailand has slowly but surely transitioned into the medical tourism capital of the world for various reasons. Reasons being that their medical service prices are extremely inexpensive, air travel is now widespread throughout the world and the quality of Thai doctors has increased dramatically due to a high medical service demand.

Quite possibly one of the biggest demands in the Thailand medical industry comes from individuals who desire a sex reassignment surgery. Thailand is well known for gender reassignment procedures; their clientele typically consists of locals. As of recent years, western expatriates have also explored the options of sex reassignment surgery in parts of Thailand. Thankfully for those expatriates, the reassignment surgery is performed by a plethora of cosmetic clinics for cheap prices.

This article is to help point you in the right directions of the institutes with the most affordable prices that offer such procedures.

The first clinic we will introduce to you is a well-known establishment based out of Pattaya, Thailand known as the Vplast Clinic. The Vplast Clinic offers a wide variety of surgical procedures, none more popular than their sex reassignment surgery.

This clinic offers gender reassignment procedures anywhere from sex reassignment surgery ฿192500 - ฿420000, which comes out to roughly $5,660 - $12,250 U.S. dollars. The price of a SRS procedure will be much more affordable at clinics like Vplast versus any western institute.

The next institute we will cover is called Maxi Cosmetic Surgery Center. Though a much smaller establishment than its counterpart Vplast Clinic, Maxi Cosmetic offers a much cheaper price for gender reassignment operations at ฿180000, which totals in at $2,294 U.S. dollars.

The last institute we will cover is called the Yanhee Hospital. Well known for their doctor’s professionalism, Yanhee is one of Thailand’s most famous hospitals for cosmetic surgeries. We’ll start off by saying that the Yanhee Hospital has a rating of 4.3/5 from 1,629 users giving it one of the best reviews of any hospital in Thailand. The price for a gender reassignment surgery will start somewhere around ฿200000 or $5,000 U.S. dollars, which is not a terrible price for such a prestigious establishment. The facility and the doctors themselves make up for any nervousness you might have about Yanhee’s set price.

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