Definition
Although people mostly
imagine a sex reassignment surgery as a procedure to reshape the
genitals of a person, the World Professional Association for
Transgender Health (WPATH) has included larger scope to the
procedures defined as sex reassignment surgery. Some of these medical
procedures are chest and breast reconstruction or augmentation,
genital reconstruction, and certain facial plastic reconstruction.
This larger definiton also includes some medically non-surgical
procedures like facial electrolysis.
To protect patients with
gender identity disorder who needs to perform sex reassignment
procedure, the American Medical Association House of Delegates
declared that the denial to these patients is a form of
discrimination and supported public and private health insurance to
cover sex reassignment surgery as a treatment recommended by
physician. This statements are also issued by other organizations
like American Psychological Association and the National Association
of Social Workers.
Male to Female or Female to Male Sex Change Difference
Male to female sex
reassignment procedure for trans women is different with female to
male for trans men. Sex reassignment procedure for trans women
includes medical construction of a vagina, facial feminization
surgery, and breast augmentation. For trans men, besides medical
construction of a penis, several other procedures like mastectomy
(breast removal procedure) and hysterectomy or male chest
reconstruction are necessary. But, in both cases, sex surgery also
includes several necessary ancilliary procedures like orchiectomy or
vaginectomy.
In trans women, medical
advancement has made it possible to childbearing, by using a donor
uterus from other natural women that is strong enought to carry an
infant without having any implication from the anti-rejection drugs.
A DNA transfer is also possible by removing DNA from the donated ovum
to be replaced by the DNA of the receiver.
Health Considerations
Not all people could
undergo a sex reassignment surgery. There are several health
considerations to pass before performing the surgery. For example,
the patient with HIV or hepatitis C may find it difficult to do a sex
reassignment surgery. Many surgeons avoid these kinds of patient due
to the safety problem. Although some medical experts agree that
avoiding patients with HIV or hepatitis C to undergo a sex
reassignment surgery is a form of discrimination, the patients
themselves are willing to pay higher fees in order to recruit a
surgeon to perform the surgery safely.
Not only HIV and
hepatitis C, other health conditions like diabetes, abnormal blood
clotting, and obesity must be considered by the patient. Obese
patient, for example, is suggested to lose weight before performing
surgery. Meanwhile, smoking patient is suggested to quit before and
after surgery. This is necessary to avoid any problems after the
surgeons.
Standards of Care
While sex reassignment
surgery sometimes feels so difficult to be performed due to financial
difficulties or minimum experienced surgeons, a document called
Standards of Care for the Health of Transsexual, Transgender, and
Gender Nonconforming People becomes a guidance or a governance by
some individuals who wants to perform the surgeries. With an
increasing number of surgeons in this field in many regions, Standard
of Care is widely spread and sometimes revised by the World
Professional Association for Transgender Health. The Standard of Care
is also becomes a guidance by many countries, including the United
States, to treat transsexualism. Standard of Care includes a period
of full time life as a member of the target sex before performing the
sex reassignment surgery.
Beside that, Standards of
Care lists several minimum requirements as guidelines for treating
transsexualism. Some of these requirements is accessing hormone
replacement from the opposite sex and other surgical interventions.
Here then comes the controversy. Many countries do not follow the
right Standards of Care, some of them insert their local standards of
care in it, like Netherlands, Germany, and Italy. Some European
Standards of Care are even based on older versions of the standards.
That makes some standards are stricted than other standards, mostly
the latest revision of Standards of Care. However, in the United
States, many professional sex reassignment surgeons apply the
Standards of Care in a more flexible term, regarding to how the
patient’s condition is, as long as it is consistent to the
Standards.
Surgeons require at least
one suggestion from an experienced mental health professional who
works in diagnosing sex identity disorder for a patient more than a
year. This suggestion is compulsory because it becomes a sign that
sex reassignment surgery is the one and only treatment to be
performed. Moreover, many medical professionals and associations
stated that no surgical interventions are required during performing
the sex reassignment surgery procedures. But, laws in many countries
are still unable to list transsexual and transgender people as the
opposite sex in the public records, except if they attach a
testimonial letter from a physician or medical experts that said that
the sex reassignment surgery has been undergone. Several strict
countries do not even allow any kind of sex change, even after sex
reassignment surgery has been performed.
1 comments:
Some surgeons perform procedures involving laser surgery, where others use methods such as radiosurgical techniques or scalpel techniques.
thanks
Smita sharma
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