Sex Reassignment Surgery-SRS

Gender Reassignment Surgery or Sex Reassignment Surgery also known as Sex Affirmation Surgery, Sex Realignment Surgery or Sex-change operation (SRS) is a expression for the surgical method by which a person's physical presence and function of their current sexual characteristics are changed to resemble that of the other gender. It is part of a process for gender identity disorder/gender dysphoria in transsexual and transgender people. It may also be performed on intersex people, often in childhood.
People who opt sex reassignment surgery are generally referred to as transsexual. More recently, people pursuing SRS often identify as transgender instead of transsexual.

"It must be clear that the result of this reconstructive surgery is absolutely irreversible and can never be as realistic as natural ones. Post SRS one can never become a genetic father or mother for entire life."

Requirements for Sex Reassignment Procedures

The minimum requirement to start Hormonal therapy or Breast Surgery is-

  • Patient must be a major (or Parental release form).
  • Must be in stable frame of mind, and are living in society as the new desired external appearance (Real Life Experience) for at least 3-months.
  • Consultation & counselling with psychiatrist (mental health physician) for at least 3-months, to rule out any abnormal mental status or infatuation or temporary attraction/any secondary gain; and approval of psychiatrist to undergo hormonal therapy and/or breast surgery.
  • Affidavit (notarized) from patient that he/she is major and can fully understand pros/cons & take the decision regarding the therapy/surgery.

Below are the requirements of SRS-

  • Patient must be a major (or Parental Release Form)
  • If married, the spouse must sign Spousal Release Form
  • Must be in stable frame of mind, and are living in society as the new desired external appearance (Real Life Experience) for at least 1-year.
  • Continuous consultation & counselling with psychiatrist (mental health physician) for at least 1-year; and approval with two independent Psychiatrists for surgery at two different intervals (a gap of at least 6-months) to rule out any abnormal mental status or infatuation or temporary attraction and IQ of patient.
  • Affidavit (notarized) from patient that he/she is a major and can take decisions regarding the surgery after fully understanding the pros & cons and understanding of irreversibility of the procedures. -
  • Most Important to keep in mind that skin without pigment is at larger risk for sun damage. Be sure to apply a broad-spectrum (UVA and UVB), high-SPF sunscreen or sunblock and use suitable safeguards against sun exposure.

Male to Female or M to F (Trans Female)

The method involved methodical removal of penis & testicles and creation of neo-vagina with penis skin, labia majora & labia minora by scrotal skin and creation of clitoris by de-bulked sensate flap of glans penis. Breast implant (Silicone cohesive gel) completes the procedure. Few further stages may be required to fine-tune the result otherwise surgery can be performed in single stage.
The post-operative result of vaginoplasty is variable. It typically allows coitus (sexual intercourse) even though sensation might not always be present. The physical factors and slimness of the male pelvis can decrease the available area to use for vaginoplasty and limit vaginal size.

Female to Male or F to M (Trans Male)

F to M is more complex and complicated procedure than M to F. The surgery is always staged and are :

  • Excision of breast, salpingo-oophorectomy, hysterectomy & excision of vagina (in Single or two stage, depending on completion of formalities)
  • Reconstruction of neo penis using microsurgical technique.
  • Placement of penile implants for penile erection.

A gap of 4-6 month is required in between each stage for proper healing of the areas. few further stages may be required to fine tune the results or to perform ancillary procedures like vocal cord surgery to change the voice etc.