Plastic Surgery Essentials for Students-Chapter 23: Gender Affirmation Surgery

Chapter 23: Gender Affirmation Surgery

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Chapter 23 of the document focuses on gender affirmation surgery, primarily addressing gender identity disorder and surgical interventions for transgender individuals. Gender dysphoria is a condition where individuals experience dissatisfaction with their anatomic gender, often leading them to seek surgical interventions to acquire characteristics of the opposite gender. The text details the prevalence of gender dysphoria, criteria for diagnosis, and stresses the importance of a multidisciplinary approach for treatment, including mental health support, hormone therapy, and surgical procedures.<br /><br />The chapter distinguishes between male-to-female (MTF) and female-to-male (FTM) surgeries. In MTF surgeries, facial alterations aim to feminize features—such as brow lifts and rhinoplasties—while chest surgeries typically involve breast augmentation. Genital reconstruction, including procedures like penile inversion, aims to create a functional and sensate neovagina.<br /><br />For FTM individuals, chest surgery involves contouring and mastectomies to masculinize the chest, often the first surgical step. Phalloplasty and metoidioplasty are discussed as methods for constructing a neophallus, with emphasis on achieving aesthetics, functional voiding, and sexual capability. Different surgical techniques and their respective pros and cons—such as using radial forearm free flaps or pedicled flaps—are analyzed. Additionally, scrotoplasty can often be performed using labia major flaps to create scrotal sacks, potentially involving implant placement.<br /><br />The chapter also includes a historical perspective on transsexualism, terminology evolution, and the role of organizations like the World Professional Association for Transgender Health in guiding medical practices. Overall, the document highlights the complexities involved in gender affirmation surgeries, the importance of individualized care, and the ongoing debate over the etiology of gender dysphoria.

Keywords

gender affirmation surgery

gender dysphoria

transgender individuals

MTF surgeries

FTM surgeries

multidisciplinary approach

genital reconstruction

phalloplasty

World Professional Association for Transgender Health

individualized care