Abstract
For individuals with pronounced gender dysphoria, surgery is the ultimate and the most radical step in the process of gender reassignment and follows a period of real-life experience and hormone treatment.
In this chapter, a complete overview is first provided of all surgical procedures, both in male-to-female and female-to-male transsexuals: These include aesthetic operations, breast surgery, and genital surgical interventions.
For the male-to-female individual, a more in-depth description is provided of facial feminizing surgery (FFS), of breast augmentation, as well as of the different techniques for vaginal reconstruction. Emphasis is placed on functional outcomes, on the reduction of complications, and on aesthetic improvements.
In the female-to-male transsexual, the subcutaneous mastectomy (SCM) or male chest contouring and the different surgical options for phalloplasty or penile reconstruction are described in more detail. The advantages and disadvantages of the different techniques are addressed.
It is concluded that in order to obtain optimal results in transgender surgery, a close cooperation between the different professionals involved is an absolute requirement.
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References
Abraham, A. G. (1931). Genitalumwandlung an zwei männlichen Transvestiten. Zeitschrift für Sexualwissenschaft und Sexualpolitik, 18, 223–226.
Beer, G. M., Budi, S., Seifert, B., Morgenthaler, W., Infanger, M., & Meyer, V. (2001). Configuration and localization of the nipple-areola complex in man. Plastic and Reconstructive Surgery, 108(7), 1947–1953.
Benjamin, H. (1966). Conversion operation. In The transsexual phenomenon (pp. 100–118). New York, NY: Julian Press.
Burcombe, R. J., Makris, A., Pittam, M., & Finer, N. (2003). Breast cancer after bilateral subcutaneous mastectomy in a female-to-male transsexual. The Breast, 12, 290–293.
Burou, G. (1973). Male to female transformation. In D. R. Laub & P. Gandy (Eds.), Proceedings of the second interdisciplinary symposium on gender dysphoria syndrome (pp. 188–194). Palo Alto, CA: Stanford University Press.
Chang, T. S., & Hwang, W. Y. (1984). Forearm flap in one stage reconstruction of the penis. Plastic and Reconstructive Surgery, 74(2), 251–258.
Cohen-Kettenis, P., & Kuiper, B. (1984). Transseksualiteit en psychotherapie. Tijdschrift voor Psychotherapie, 3, 153.
Coleman, E., Bockting, W., Botzer, M., Cohen-Kettenis, P., DeCuypere, G., Feldman, J., et al. (2011). Standards of care for the health of transsexual, transgender, and gender-nonconforming people, Version 7. International Journal of Transgenderism, 13, 165–232.
Cregten-Escobar, P., Bouman, M. B., Buncamper, M. E., & Mullender, M. G. (2012). Subcutaneous mastectomy in female-to-male transsexuals: A retrospective cohort-analysis of 202 patients. The Journal of Sexual Medicine, 9(12), 3148–3153. doi:10.1111/j.1743-6109.2012.02939.x.
De Cuypere, G., T’Sjoen, G., Beerten, R., Selvaggi, G., De Sutter, P., Hoebeke, P., et al. (2005). Sexual and physical health after sex reassignment surgery. Archives of Sexual Behavior, 36, 679–690.
Edgerton, M. (1984). The role of surgery in the treatment of transsexualism. Annals of Plastic Surgery, 13, 473–481.
Eldh, J. (1993). Construction of a neovagina with preservation of the glans penis as a clitoris in male transsexuals. Plastic and Reconstructive Surgery, 91, 895–903.
Ganly, I., & Taylor, E. W. (1995). Breast cancer in a transsexual man receiving hormone replacement therapy. British Journal of Surgery, 82, 341.
Gilbert, D. A., Horton, C. E., Terzis, J. K., Devine, C. J., Jr., Winslow, B. H., & Devine, P. C. (1987). New concept in phallic reconstruction. Annals of Plastic Surgery, 18(2), 128–136.
Giraldo, F., Esteva, I., Bergero, T., Cano, G., Gonzalez, C., Salinas, P., et al. (2004). Corona glans clitoroplasty and urethropreputial vestibuloplasty in male-to-female transsexuals: Vulval aesthetic refinement by the Andalusia Gender Team. Plastic and Reconstructive Surgery, 114, 1543–1550.
Hage, J. J., Becking, A. G., de Graaf, F. H., & Tuinzing, D. B. (1997). Gender-confirming facial surgery: Considerations on the masculinity and femininity of faces. Plastic and Reconstructive Surgery, 99, 1799–1807.
Hage, J. J., Bouman, F. G., de Graaf, F. H., & Bloem, J. J. (1993). Construction of the neophallus in female-to-lake transsexuals: The Amsterdam experience. Journal of Urology, 6, 1463–1468.
Hage, J. J., & De Graaf, F. H. (1993). Addressing the ideal requirements by free flap phalloplasty: Some reflections on refinements of technique. Microsurgery, 14, 592–598.
Hage, J. J., & Kesteren, P. J. M. (1995). Chest-wall contouring in female-to-male transsexuals: Basic considerations and review of the literature. Plastic and Reconstructive Surgery, 96(2), 386–391.
Hoebeke, P., De Cuypere, G., Ceulemans, P., & Monstrey, S. (2003). Obtaining rigidity in total phalloplasty: Experience with 35 patients. Journal of Urology, 169, 221–223.
Hoebeke, P., Selvaggi, G., Ceulemans, P., De Cuypere, G., T’Sjoen, G., Weyers, S., et al. (2005). Impact of sex reassignment surgery on lower urinary tract function. European Journal of Urology, 47, 398–402.
Isshiki, N. (1989). Phonosurgery—Theory and practice. Berlin: Springer.
Kanhai, R. C. J., Hage, J. J., Asscheman, H., & Mulder, J. W. (1999). Augmentation mammaplasty in male-to-female transsexuals. Plastic and Reconstructive Surgery, 104, 542–549.
Karim, R. B., Hage, J. J., Bouman, F. G., de Ruyter, R., & van Kesteren, P. J. M. (1995). Refinements of pre, intra, and post-operative care to prevent complications of vaginoplasty in male transsexuals. Annals of Plastic Surgery, 35, 279–284.
Karim, R. B., Hage, J. J., & Cuesta, M. A. (1996). Rectosigmoid neocolpopoiesis for male-to-female transsexuals: Amsterdam experience. Annals of Plastic Surgery, 36, 388–391.
Kuiper, B. M. A., & Cohen-Kettenis, P. (1988). Sex reassignment surgery: A study of 141 Dutch transsexuals. Archives of Sexual Behavior, 17, 439–457.
Laub, D. R., & Fisk, N. (1974). A rehabilitation program for gender dysphoria syndrome in surgical sex change. Plastic and Reconstructive Surgery, 53, 388–403.
Monstrey, S., Hoebeke, P., Dhont, M., De Cuypere, G., Rubens, R., Moerman, M., et al. (2001). Surgical therapy in transsexual patients: A multi-disciplinary approach. Acta Chirurgica Belgica, 101, 200–209.
Monstrey, S., Hoebeke, P., Selvaggi, G., Ceulemans, P., Van Landuyt, K., Blondeel, P., et al. (2009). Penile reconstruction: Is the radial forearm flap really the standard technique. Plastic and Reconstructive Surgery, 124, 510–518.
Monstrey, S., Selvaggi, G., & Ceulemans, P. (2007). Surgery in the female to male transsexual patient. In E. Randi, M. Stan, & E. Evan (Eds.), Principles of transgender medicine and surgery (pp. 105–133). New York, NY: The Haworth Press.
Monstrey, S., Selvaggi, G., Ceulemans, P., Van Landuyt, K., Bowman, C., Blondeel, P., et al. (2008). Chest-wall contouring surgery in female-to-male transsexuals: A new algorithm. Plastic and Reconstructive Surgery, 21(3), 849–859.
Sadove, R. C., Sengezer, M., McRobert, J. W., & Wells, M. D. (1993). One-stage total penile reconstruction with a free sensate osteocutaneous fibula flap. Plastic and Reconstructive Surgery, 92(7), 1314–1325.
Selvaggi, G., Ceulemans, P., De Cuypere, G., Van Landuyt, K., Blondeel, P., Hamdi, M., et al. (2005). Gender identity disorder: General overview and surgical treatment for vaginoplasty in male to female transsexuals. Plastic and Reconstructive Surgery, 116, 135–145.
Selvaggi, G., Monstrey, S., Ceulemans, P., T’Sjoen, G., De Cuypere, G., & Hoebeke, P. (2007). Genital sensitivity after sex reassignment surgery in transsexual patients. Annals of Plastic Surgery, 58, 427–433.
Selvaggi, G., Monstrey, S., Hoebeke, P., Ceulemans, P., Van Landuyt, K., Hamdi, M., et al. (2007). Donor site morbidity of the radial forearm free flap after 125 phalloplasties in gender identity disorder. Plastic and Reconstructive Surgery, 118, 1171–1177.
Sengezer, M., Ozturk, S., Deveci, M., & Odabasi, Z. (2004). Long-term follow-up of total penile reconstruction with sensate osteocutaneous free fibula flap in 18 biological male patients. Plastic and Reconstructive Surgery, 114, 439–450.
Symmers, W. S. (1968). Carcinoma of breast in transsexual individuals after surgical and hormonal interference with the primary and secondary sex characteristics. British Medical Journal, 2(597), 82–85.
Webster, J. P. (1946). Mastectomy for gynecomastia through a semicircular intra-areolar incision. Annals of Surgery, 124, 557.
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Monstrey, S.J., Buncamper, M., Bouman, MB., Hoebeke, P. (2014). Surgical Interventions for Gender Dysphoria. In: Kreukels, B., Steensma, T., de Vries, A. (eds) Gender Dysphoria and Disorders of Sex Development. Focus on Sexuality Research. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-7441-8_15
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