• Kayla Hui and Saanvi Jain

Advancements in Gender Reassignment

Gender Reassignment is used to help people with gender dysphoria, which is those who feel that they were born in the wrong gender. This can result in strong discomfort or distress caused by a discrepancy between a person’s gender identity and their biological sex. Gender dysphoria often manifests early in childhood and can persist for years before patients receive counseling or treatment. Untreated gender dysphoria can result in a poor quality of life for transgender people. For this reason gender reassignment is an important step to reduce gender dysphoria. The most common types of gender reassignment are surgery or hormones.

Patients most often receive hormone therapy first. Hormones are used to suppress the secondary sex characteristics of the biological gender, this allows them to appear more like the desired sex. Hormone therapy helps to alter hormone levels in order to match gender identity, this is used to maintain hormone levels in the normal range for the target gender. Hormone therapy is most effective if treatment begans before the development of secondary sex characteristics. This allows teens to go through puberty as the target gender. Research has shown that hormone therapy can be safe and effective. Overall, this will reduce gender dysphoria and reduce psychological and emotional distress.

An example of hormone therapy is feminizing hormone therapy. Feminizing hormone therapy may also be called gender-affirming hormone therapy. This type of hormone therapy works to block the hormone testosterone. It is then replaced with estrogen to decrease testosterone production and induce feminine secondary sex characteristics. Secondary sex characteristics are physical characteristics that develop during puberty which distinguishes between the sexes. However these characteristics are not directly involved in reproduction. An example of this is facial and chest hair in males or the deepening of one’s voice.

The opposite of feminizing hormone therapy is masculinizing hormone therapy, which is another type of gender-affirming hormone therapy. Masculinizing hormone therapy is through the hormone testosterone, and is used to suppress menstrual cycles and decrease the production of estrogen. Changes by these medications can be temporary or permanent.

Unfortunately, there are risks that come with hormone therapy. Hormone therapy can impact one’s fertility and cause other health problems, including cancer. Hormone therapy can result in deep vein thrombosis and pulmonary embolism. This may also result in excessive weight gain or possible acne. Both types of hormone therapy, feminizing and masculinizing, may also result in infertility. For this reason hormonal gender reassignment should only be initiated after meticulous individual consideration and the approval of a psychiatrist or psychotherapist. Before beginning hormone therapy, the patient is also extensively screened for possible risk factors.

Another form of gender reassignment is surgery. This can be done in conjunction with hormone therapy, or following hormone therapy. Gender reassignment surgery is more invasive than hormone therapy, and contains more risks. For this reason surgery is typically the last step in the physical transition process. Before surgically transitioning many healthcare providers require patients to be both formally diagnosed with gender dysphoria and to undergo counseling.

Surgical transition will often occur in multiple procedures. Biological males who are transitioning to females will have their testicles and penis removed. The tissue from the penis will be used to construct a vagina and clitoris. A labia can be made from scrotal skin. The urethra will also be shortened. Their prostate gland, which is used to produce fluid that nourishes and transports sperm, may also be removed. Following surgery, vaginal dilators are used to keep the new vagina open and flexible.

Many biological males transitioning to females may also receive facial feminization surgery to make their appearance more feminine. This includes moving a hairline forward to create a smaller forehead. They may also have their lips and cheekbones augmented, or having a jaw and chin reshaped and resized. Facial feminization is often performed because several facial features, such as the jaw and brow, reflect gender differences. Also, since facial features are readily see, having feminine features can prevent harassment and discrimination.

For biological females transitioning to males, surgical transition can be more complicated. To complete this, breasts, ovaries, and the uterus are removed. The vagina is also closed. A penis and scrotum may be formed from other tissue or a penile implant. The urethra is also extended to allow for the patient to urinate while standing. As patients adjust to their new bodies and lifestyles, psychotherapy is heavily recommended.

Overall there are many advancements in gender reassignment that help to reduce gender dysphoria. However every case is different, not all people with gender dysphoria decide to have surgery. While some people find that hormone therapy is sufficient for them. Other people feel comfortable living as the opposite gender without medical intervention. The many advancements in gender reassignment help to provide transgender people with plenty of options to better affirm their gender identity.