From the book
"Everything You Ever Wanted to Know About Sex Change* *but were afraid to ask"
Edited by Melanie Anne Phillips founder
of the Transgender Community Forum on America Online
The Nuts and Bolts
In truth, there is much more to sex reassignment surgery than the
surgery itself. Still, the nuts and bolts of the actual procedure seems to be a topic
which most piques the interest. In deference to this interest, I'm putting a description
of the specific of the surgery right up front. With that out of the way, we can continue
or exploration into the whole phenomenon, including it's personal, social, financial, and
legal ramifications.
What is Actually Done?
Technically, you cannot truly change one's sex. That's why the
procedure is not really called "sex change surgery" but "sex reassignment
surgery". The idea is to alter the physical appearance of a person's anatomy to
approximate as nearly as possible the anatomic arrangement of the other sex.
Part of this procedure involves extended hormone therapy, which
alters secondary sexual characteristics. In male to female transsexuals, it leads to the
growth of breasts and the build up of body fat in particular areas. In female to male
transsexuals it lowers the voice and causes body hair and beard to grow. (It should be
noted that the male to female transsexual's voice is not changed by taking estrogen.)
The Long and the Short of it
Contrary to popular belief, the penis is not amputated during SRS.
Rather, the internal penile tissue is mostly removed, but the outer skin is left attached,
inverted and inserted into the body inside out as the new vagina. The testicles are
removed, but the scrotal tissue is also left attached and used to fashion the vaginal lips
or labia through standard plastic surgery procedures.
Here is how it happens. Once the patient has been prepped, sedated,
wheeled into the operating room and anesthetized, the doctor slits the skin of the penis
lengthwise from the head or glans down to the base on the underside. The skin is then
peeled away from around the penis, but since the slit only opened the penis, the base of
the skin is still attached.
The penile skin is then turned inside out, much like one might turn
a sock inside out. When this is done, the slit is stitched back together, creating an
inverted penis, which will ultimately form the new vagina.
Before this occurs, a rather miraculous, yet simple procedure is
performed. Earlier, when the internal penile tissue was removed, a small stub of tissue
was left behind, still attached. This is erectile tissue, which becomes stiff when
stimulated, and also carries sexual sensation.
A tiny slit, perhaps a half-inch in length, is made in the new,
inverted penis near the base where it is still attached. The stub of erectile tissue is
pushed through the slit, forming the equivalent of a clitoris, and providing the
opportunity for complete orgasm and sexual satisfaction after surgery. In addition, a
second tiny slit is made below the one for the clitoris. The urinary tube is rerouted to
this second slit to create a typical female urinary opening.
Once this procedure has been accomplished, the skin and muscles of
the lower abdomen are lifted up with surgical instruments, providing a gap near the pelvic
bone. The inverted penis is pushed into the gap, still attached at the base, so that it
hinges down and into the proper location for a vagina.
To allow for proper vaginal contractions later, some of the
abdominal muscles are repositions around to new vagina so that they can squeeze in on it,
both by conscious control and also automatically during orgasm.
The new vagina is filled with surgical gauze to maintain shape, and
then anchored in place with a thin surgical wire which enters the abdomen from the
outside, runs under the pelvic bone, through the new vagina, back up around the pelvic
bone and out the abdomen again. Once the vagina has healed in place, which takes
approximately seven days, the wire is removed by the surgeon, who simply slips it out.
Post Op Information
The post op patient will remain in bed for seven to eight days. The
pain of surgery is not at all as bad as one might expect. The only real pain comes if one
sneezes, coughs, or laughs. The procedure does take a lot out of one's reserves, so that
the patient drifts in and out of sleep and is too weak to roll over unassisted for the
first day or so.
For the first three or four days, the patient is on a catheter for
urinary purposes, which allows urine to drain through a tube to a bag on the side of the
hospital bed. This is standard medical procedure for all urinary surgeries. In addition,
any use of general anesthetic usually causes a shut down of bowel function for three or
four days. Many post op patients require an enema to get the system flushed out and
working again.
Urination after the catheter is removed is painful and difficult at
first, but not to the point one cannot bear it. Over the course of the first few post op
weeks, urination becomes increasingly easier, and the bladder is able to hold more and
more until pre-surgical bladder capacity is usually recovered.
Most patients are back at work two to three weeks after surgery. The
area of surgery will be sore for more than a month. Sexual sensation may return in as
little as two weeks. Sexual intercourse can be allowed six weeks after surgery.
Back
To
Transexuals.com
Home Page |
