Feminizing vaginoplasty is one of the methods of surgical sex change, in which the removal of male genital organs and the formation of female ones. After this operation, a transsexual can lead a normal sexual life and even enjoy sexual intercourse. Let's take a look at how feminizing vaginoplasty is performed, what preliminary preparation is needed and what complications are possible.
Transsexualism and surgical sex reassignment
Transsexualism is a condition in which a person feels uncomfortable in his own body and wants to change his gender to the opposite. Do not confuse transsexualism with homosexuality and transvestism. Same-sex attraction does not mean that a person has doubts about their own gender or wants to change their gender. Transvestites, on the other hand, can change into clothes of the opposite sex, while they do not burn with desirechange your body with hormone therapy or surgery.
It is worth noting that most transsexuals have suicidal tendencies due to rejection of their own body, problems with self-identification, rejection by relatives and society. Only radical measures can help in this case: hormone therapy, sex reassignment surgery, vaginoplasty and breast plastic surgery.
Not all transsexuals decide on the most drastic measures. Many stop at stages where they begin to feel comfortable. We list the main stages and options for changing sex as their complexity increases:
- Without surgery, with hormone replacement therapy. In the case of taking hormones, a man's body changes, changes are especially noticeable if a man starts taking medications in adolescence, when the body has not yet fully formed. When taking hormones, a man's genitals shrink, and complete chemical castration occurs within 6-12 months.
- Surgical castration - removal of the testicles.
- Removal of the penis and testicles, the formation of external genitalia.
- Vaginoplasty.
Feminizing vaginoplasty - what is it? This is an operation, as a result of which the penis and testicles are removed, the external genitalia are formed and the vagina is formed, suitable for full sexual intercourse.
First sex change operations
The first mention of successfullyconducted sex reassignment operations appeared in 1926. The German scientist M. Hirschfeld removed the mammary glands of a woman who wanted to be a man, as well as the penis of a man who wanted to become a woman.
In the early twentieth century, transgender people tried not to advertise their desire to change their gender, because it was considered one of the signs of schizophrenia. On the other hand, there were a large number of homosexuals who wanted to change their sex, because in many countries homosexuality was illegal.
History is known Danish artist Einar Wegener, who decided to have a sex change operation. He underwent two operations: on the first man, the testicles and penis were removed, and during the second, the uterus and ovaries were transplanted. Einar wanted to become a mother, and therefore decided on this. However, in those days, doctors were not yet aware of antigenic incompatibility, therefore, over time, foreign organs began to be rejected by the body, from which Wegener died.
History
Initially, vaginoplasty (vaginoplasty) was more the prerogative of women. With its help, external and internal defects of the female genital organs were corrected. In 1950, A. Macloyd developed a technique that was used for female vaginoplasty using a split skin flap.
The history of feminizing vaginoplasty begins in 1970, when M. T. Edgerton and D. Bull described transgender vaginal plasty using perineal flaps.
In 1978, N. J. Panday and O. H. Stutwil described the technique of vaginoplasty in transsexuals withusing tissue flaps from the abdominal cavity.
In 1987, the history of feminizing vaginoplasty took a new turn thanks to Dr. L. P. Small, who began to use the skin of the penis and scrotum to form the vagina, which is still widely practiced today.
In 1993, S. Perovik introduced the technique of penile inversion with sensitive clitoroplasty. With this method, the tissues of the glans penis were used to form a sensitive clitoris, as well as a sensitive layer throughout the neovaginal area.
New methodologies are still being developed. This is due to attempts to find the most advanced methods of creating a functional and visually indistinguishable from the natural vagina, while with minimal operational risks and subsequent complications.
Preparation for surgery and necessary documents
In some clinics, the requirements for feminizing vaginoplasty may vary slightly. Usually preparation for the operation can take about two years. First, the patient must prove that he is in fact a transgender: he considers his current gender to be erroneous and for his more comfortable existence in society, a sex change is necessary.
The main indication for feminizing vaginoplasty is the conclusion of a psychiatrist. Often, the patient is prescribed hormone therapy. At least a year he must live in a female form. If after that he still insists on the operation, while the doctor does not have any psychiatric abnormalitiesdiscovers, the patient receives a psychiatric report. Sex reassignment surgery is only performed on adults.
Contraindications for surgery
There is a set of contraindications due to which a patient may be denied a gender reassignment surgery:
- minor age;
- homosexuality;
- alcoholism or drug addiction;
- no psychiatric opinion on transsexuality;
- presence of mental illness and problems;
- old age.
Preparation
It should be noted that the average age of patients who decide to undergo feminizing vaginoplasty is 37 years, the average duration of preparation for surgery is 3.5 years.
Hormone therapy starts at least six months before surgery. It is necessary to prevent post-castration syndrome and simplify social adaptation.
A man who decides on such an operation must understand that its consequences are irreversible. The removal of the testicles and penis will make it impossible for a man to have children in the future. Many doctors advise saving your sperm before surgery in case you want to have children in the future. In any case, if the patient has even a drop of doubt about the advisability of feminizing vaginoplasty, you should abandon this idea, because it will be impossible to return everything to its place.
Penal inversion method
Most popular andA simple technique for feminizing vaginoplasty is the penile inversion technique. With it, the vagina is formed using the tissues of the penis and scrotum. The operation is considered quite simple, its duration is about 4 hours.
The following advantages of this method can be distinguished:
- the operation is simple, which means the risk of complications is minimal;
- quick postoperative recovery: about 4-6 days;
- no risk of intestinal adhesion or peritonitis;
- relatively low cost of operation.
The disadvantages of this technique include:
- need for constant neovaginal stretching;
- requires artificial lubrication for sexual contact;
- painful electrolysis of hair from the scrotum;
- with a small penis, it is impossible to achieve a large vagina. It is worth noting that hormone therapy often leads to a reduction in the penis and scrotum, from which there may not be enough tissue during the operation.
The penal inversion method is the most popular due to its simplicity and low cost.
Sigmoid method
With the sigmoid method of feminizing vaginoplasty, a part of the sigmoid colon about 18 cm long is cut off from the patient, and the intestines are then sutured. This part of the intestine will be used to form the neovagina.
The main advantages of this technique:
- fluid secreted by the intestines becomes a natural lubricantduring intercourse;
- no likelihood of neovaginal tightening after surgery;
- no risk of hair growth in the vagina;
- vagina looks more natural;
- does not require constant stretching.
Also, this method has its drawbacks:
- the operation is quite complicated, besides, it involves the intestines, which may affect its condition;
- long period of postoperative rehabilitation;
- the vagina can smell and leak;
- possibility of complications;
- very high cost.
The sigmoid method is less popular than the penile inversion method because of its cost and complexity. However, it may be suitable for patients with a small penis in order to shape the vagina to a more appropriate size for intercourse.
Complications
Possible complications depend on the complexity of the operation, the age of the patient, his physical condition, qualifications and experience of the surgeon. It is worth remembering that any surgical intervention carries certain risks for the patient's he alth.
Let's list the main possible unpleasant consequences of gender reassignment surgery:
- lack of sensation in the neovagina and clitoris;
- rectal fistula formation;
- hair growth inside the neovagina;
- necrosis of penile and scrotal skin;
- bleeding;
- peritonitis;
- urinary disorder.
Rehab
Inpatient treatmentthe patient who changed sex by the method of penile inversion lasts up to 6 days, provided there are no postoperative complications. A tampon is inserted into the vaginal area for a period of 12 days. The catheter is inserted into the urethra for a period of about 6 days.
With the sigmoid method of feminizing vaginoplasty, an incision is made in the abdominal cavity, which means that the patient's rehabilitation period lasts longer. After the operation, it is necessary to process the postoperative suture and monitor the condition of the intestine.
After the operation, the patient should go on a diet for a while. Eliminate from your diet fruit and vegetable juices, milk and other products that contribute to increased gas formation in the intestines.
It is worth giving up increased sexual and physical activity until full recovery.
Consequences of the operation
Surgeons claim that the genitals formed as a result of feminizing vaginoplasty can only be distinguished from real ones by another surgeon. During intercourse, the partner will not feel the difference. A transgender girl after feminizing vaginoplasty can have a relationship with a heterosexual man without even revealing her innate gender.
Most transsexuals who have undergone a gender reassignment surgery are completely satisfied with the result. Their life before and after feminizing vaginoplasty is drastically different. Sex reassignment surgery helps them accept their own bodies.
However, it is worth noting a certain number of dissatisfied. One part is dissatisfied with the results of the operation, as it did not justify themexpectations to the fullest. For example, this is possible with a small size of the vagina as a result of surgery or postoperative complications. There are transsexuals who regret their decision to have surgery. They admit that their decision was not fully considered.
Thus, feminizing vaginoplasty is a fairly popular operation among transsexuals, which results in the removal and modification of male genital organs and the formation of female ones in their place. The choice of vaginoplasty technique should be made based on the expected results. Since many transgender people are not sexually active after surgery, the cheaper and simpler method of penile inversion is likely to be more suitable for them. The sigmoid method helps to achieve more natural results.
