Everything you need to know about gender affirming surgery

Gender affirmation surgery, also known as gender confirmation surgery, helps people transition to their ‘self-identified’ gender, giving them the physical appearance and functional abilities of the gender they know themselves to be. This might include anything from facial surgery to bottom surgery and top surgery, usually used as a treatment to ease symptoms of gender dysphoria.

What this means will vary from person to person, and is different for children, young people and adults. According to the NHS, waiting times for referral and treatment are currently long and for children under 18, they’ll usually be referred to the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Foundation Trust first before a treatment plan is put in place with a team of experts including psychologists and adolescent psychiatrists.

For adults who have chosen to have surgery to permanently alter body parts associated with their biological sex, they are first referred to a Gender Dysphoria Clinic (GDC) and seen by a multidisciplinary team of healthcare professionals, who offer ongoing assessments, treatments, support and advice, including psychological support, cross-sex hormone therapy and speech and language therapy. Based on the recommendations of doctors at the gender dysphoria clinic, they will be referred to a specialist surgeon outside the clinic who is an expert in this type of surgery.

Here’s everything you need to need to know about gender affirmation surgery.

What is gender-affirming surgery?

Sex reassignment surgery refers to procedures that help people transition to their self-identified gender. Today, many people prefer to use the terms gender affirmation or confirmation surgery.

Who has gender-affirming surgery and why?

People may have surgery so that their physical body matches their gender identity. People who choose gender affirmation surgery do so because they experience gender dysphoria. Gender dysphoria is the distress that occurs when your sex assigned at birth does not match your gender identity.

What are the types of gender-affirming/sex reassignment surgery?

“Gender-affirming surgical procedures can have a significant impact on a patient’s overall wellbeing and are often a critical step for many in their transition,” says plastic surgeon Dr Paul Banwell.

Dr. Banwell adds: “With regards to available procedures, breast augmentation can add volume and shape for a more feminine appearance. By contrast, mastectomy involves the removal of breast tissue and therefore masculinises the chest.

“Body contouring can also align with both masculine and feminine ideals. We can look at liposuction and fat grafting to redistribute body fat to areas such as the hips and buttocks for a more feminine appearance whilst defining the torso may be necessary for masculinisation. Of course this is all based on the individual’s needs and carefully decided through a thorough consultation period.”

According to the NHS, there are various surgical procedures involved when it comes to sex reassignment.

Surgery for trans men

Common chest procedures for trans men (trans-masculine people) include:

• removal of both breasts (bilateral mastectomy) and associated chest reconstruction
• nipple repositioning
• dermal implant and tattoo