West of England Specialist Gender Identity Clinic

Total Page：16

File Type：pdf, Size：1020Kb

West of England Specialist Gender Identity Clinic Trans man Fact sheet Surgery and sexual orientation 1 Surgery and sexual orientation Once you have spent around a year living in the social role that matches your gender, you and your multi disciplinary team may feel that you are ready to decide whether to have surgery to permanently alter your sex. This is a big, life changing decision and the team will support you in helping you decide if it right for you. The most common options are outlined below, but you can talk to members of your team, and the surgeon at your consultation, about a whole range of options. Trans man surgery For trans men, surgery may involve: A hysterectomy (removal of the womb) A salpingo-oophorectomy (removal of the fallopian tubes and ovaries) Construction of a penis using phalloplasty or a metoidioplasty A phalloplasty uses the existing vaginal tissue and skin taken from the inner forearm to create a penis. A metoidioplasty involves creating a penis from the clitoris, which has been enlarged through hormone therapy. 2 The aim of this type of surgery is to create a functioning penis, which allows you to pass urine standing up and to retain sexual satisfaction. You may need to have more than one operation to achieve this. After surgery After surgery, the vast majority of trans people are happy with their new sex and feel comfortable with their gender identity. One review of a number of studies that were carried out over the last 20 years found that 96% of people who had gender reassignment surgery were satisfied, however not all data can be verified. Following gender confirmation surgery, one possible complication is that people may face prejudice or discrimination because of their condition. Treatment can sometimes leave people feeling: Isolated if they are not with people who understand what they are going through Stressed about or afraid of not being accepted socially Discriminated at work There are legal safeguards to protect against discrimination in the 2010 Equalities Act, but you may have to deal with other types of prejudice. If you are feeling anxious or depressed since having your treatment, speak to your GP or a healthcare professional at the clinic. 3 Sexual orientation Once transition has been completed, it is possible to experience a change of sexual orientation, however this varies greatly from person to person, and the sexual orientation of many trans people does not change after transition. If you are going through the process of transition, you may not know what your sexual preference will be until it is complete. However, try not to let this worry you. For many people, the issue of sexual orientation is secondary to the process of transition itself. The West of England Specialist Gender Identity Clinic The Laurels 11-15 Dix’s Field Exeter EX1 1QA Tel: 01392 677077 Email:[email protected] 4 .

Copy Link

Recommended publications

Transgender Equality
THE REPORT OF THE About the National Center for Transgender Equality The National Center for Transgender Equality (NCTE) is the nation’s leading social justice policy advocacy organization devoted to ending discrimination and violence against transgender people. NCTE was founded in 2003 by transgender activists who recognized the urgent need for policy change to advance transgender equality. NCTE now has an extensive record winning life-saving changes for transgender people. NCTE works by educating the public and by influencing local, state, and federal policymakers to change policies and laws to improve the lives of transgender people. By empowering transgender people and our allies, NCTE creates a strong and clear voice for transgender equality in our nation’s capital and around the country. © 2016 The National Center for Transgender Equality. We encourage and grant permission for the reproduction and distribution of this publication in whole or in part, provided that it is done with attribution to the National Center for Transgender Equality. Further written permission is not required. RECOMMENDED CITATION James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016).The Report of the 2015 U.S. Transgender Survey. Washington, DC: National Center for Transgender Equality. The Report of the 2015 U.S. Transgender Survey by: Sandy E. James Jody L. Herman Susan Rankin Mara Keisling Lisa Mottet Ma’ayan Anafi December 2016 Table of Contents Acknowledgements ...............................................................................................................1
[Show full text]
Phallo-After-Meta.Pdf
SURGEON'S CORNER The Surgical Techniques and Outcomes of Secondary Phalloplasty After Metoidioplasty in Transgender Men: An International, Multi-Center Case Series Muhammed Al-Tamimi, MD,1,2,3 Garry L. Pigot, MD,2,3 Wouter B. van der Sluis, MD, PhD,1,3 Tim C. van de Grift, MBA, MD, PhD,1,3,4 R. Jeroen A. van Moorselaar, MD, PhD,2 Margriet G. Mullender, MBA, PhD,1,3,4 Romain Weigert, MD,5 Marlon E. Buncamper, MD, PhD,1,3,4,6 Müjde Özer, MD,1,3,4 Kristin B. de Haseth, MD,1,4 Miroslav L. Djordjevic, MD, PhD,7 Christopher J. Salgado, MD,8 Maud Belanger, MD, PhD,9 Sinikka Suominen, MD, PhD,10 Maija Kolehmainen, MD,10 Richard A. Santucci, MD,11 Curtis N. Crane, MD,11 Karel E. Y. Claes, MD,12 Stan Monstrey, MD, PhD,12 and Mark-Bram Bouman, MD, PhD1,3,4,6 ABSTRACT Introduction: Some transgender men express the wish to undergo genital gender-affirming surgery. Metoi- dioplasty and phalloplasty are procedures that are performed to construct a neophallus. Genital gender-affirming surgery contributes to physical well-being, but dissatisfaction with the surgical results may occur. Disadvantages of metoidioplasty are the relatively small neophallus, the inability to have penetrative sex, and often difficulty with voiding while standing. Therefore, some transgender men opt to undergo a secondary phalloplasty after metoidioplasty. Literature on secondary phalloplasty is scarce. Aim: Explore the reasons for secondary phalloplasty, describe the surgical techniques, and report on the clinical outcomes. Methods: Transgender men who underwent secondary phalloplasty after metoidioplasty were retrospectively identified in 8 gender surgery clinics (Amsterdam, Belgrade, Bordeaux, Austin, Ghent, Helsinki, Miami, and Montreal).
[Show full text]
Challenging Gender Norms
Behavioral Health Care Outside the Binary Sand C. Chang, PhD September 22, 2018 An Everyday Example: Challenging Gender Norms 2 Illustrated by Gemma Correll 3 Illustrated by Gemma Correll 4 Illustrated by Gemma Correll 5 Illustrated by Gemma Correll 6 Illustrated by Gemma Correll 7 Illustrated by Gemma Correll 8 Objectives • Increase knowledge of the lives and experiences of people whose identities do not align with binary models of gender. • Increase awareness of the common challenges that nonbinary and people face. • Increase clinical competency and skill in working with nonbinary people. Basic Terms for here and now 10 THE GENDER BINARY System of classifying gender into two dichotomous, fixed categories Male Female Man Woman Masculine Feminine NONBINARY Terms that describe people who do not fully identify with binary categories of male/man/masculine or female/woman/feminine A Few Related Terms . Genderqueer . Gender non-conforming (GNC) . Gender expansive . Enby (instead of NB, as NB is sometimes used to refer to non-Black, as in NBPOC) 13 One perspective 14 Nonbinary: The Basics • Some nonbinary people define themselves in relation to concepts of male/man and female/woman (e.g., fluidly moving between, neither, both, in the middle), while others do not (alternate gender). • Medicalized narratives deny the existence of people who do not fit neatly into the gender binary system. • Nonbinary people may or may not identify as transgender. Nonbinary Identities: Historical and Global Context • Nonbinary people and expressions of gender have existed for centuries • Not a Western phenomenon • Evidence of nonbinary people within North America, Asia, and Europe • Erasure of nonbinary expressions of gender due to colonialism Just A Few Nonbinary Identities • Genderqueer • Gender fluid • Nonbinary • Demi gender • Gender neutral • Pangender Tip: It’s not necessary • Neutrois • Two-spirit to know the • Agender • Hijra definitions of every • Genderless • Ladyboi identity.
[Show full text]
Gender Dysphoria Treatment – Commercial Medical Policy
UnitedHealthcare® Commercial Medical Policy Gender Dysphoria Treatment Policy Number: 2021T0580J Effective Date: April 1, 2021 Instructions for Use Table of Contents Page Related Commercial Policies Coverage Rationale ....................................................................... 1 • Blepharoplasty, Blepharoptosis and Brow Ptosis Documentation Requirements ...................................................... 3 Repair Definitions ...................................................................................... 4 • Botulinum Toxins A and B Applicable Codes .......................................................................... 5 • Cosmetic and Reconstructive Procedures Description of Services ................................................................. 9 • Gonadotropin Releasing Hormone Analogs Benefit Considerations .................................................................. 9 Clinical Evidence ......................................................................... 10 • Habilitative Services and Outpatient Rehabilitation U.S. Food and Drug Administration ........................................... 15 Therapy References ................................................................................... 15 • Panniculectomy and Body Contouring Procedures Policy History/Revision Information ........................................... 16 • Rhinoplasty and Other Nasal Surgeries Instructions for Use ..................................................................... 17 Community Plan Policy • Gender Dysphoria
[Show full text]
Gender-Affirming Surgery: Phalloplasty and Metoidioplasty
UCHealth Integrated Transgender Program Gender-Affirming Surgery: Phalloplasty and Metoidioplasty Thank you for choosing the UCHealth Integrated Transgender Program – Anschutz Medical Campus at the University of Colorado Hospital. We are excited that you are taking these steps to affirm who you are. We want to help you as you move toward a physical appearance that fits with your gender identity. This booklet gives you the information to learn about gender-affirming surgeries and what to expect as a patient with our program. Please feel free to contact our office with questions or to talk with one of our providers any time. Table of contents. What is gender-affirming surgery? Who is a good candidate for gender-affirming surgery? Genital reconstruction surgery—male genitalia Phalloplasty surgery types and stages Metoidioplasty surgery Risks and complications of surgery Preparing for surgery What to expect after surgery and discharge from the hospital Follow-up appointments Checklist for surgery What is gender-affirming surgery? Gender-affirming surgery is a “standard of care” treatment to reduce gender dysphoria. Standard of care means that doctors and medical experts believe this is the best treatment for a medical condition. Gender dysphoria can happen when a person’s gender identity is not the sex that was assigned to them at birth. The goal of gender-affirming surgery is to change the features of the body which often cause this dysphoria. The surgeries will create body features that match your gender identity. These surgeries cannot be reversed. Many studies have shown that surgery, along with hormone therapy, can lessen gender dysphoria in many people.
[Show full text]
Gender Dysphoria Treatment – Community Plan Medical Policy
UnitedHealthcare® Community Plan Medical Policy Gender Dysphoria Treatment Policy Number: CS145.I Effective Date: March 1, 2021 Instructions for Use Table of Contents Page Related Community Plan Policies Application ..................................................................................... 1 • Blepharoplasty, Blepharoptosis, and Brow Ptosis Coverage Rationale ....................................................................... 1 Repair Definitions ...................................................................................... 3 • Botulinum Toxins A and B Applicable Codes .......................................................................... 4 • Cosmetic and Reconstructive Procedures Description of Services ................................................................. 8 • Gonadotropin Releasing Hormone Analogs Benefit Considerations .................................................................. 9 Clinical Evidence ........................................................................... 9 • Panniculectomy and Body Contouring Procedures U.S. Food and Drug Administration ........................................... 14 • Rhinoplasty and Other Nasal Surgeries References ................................................................................... 14 • Speech Language Pathology Services Policy History/Revision Information ........................................... 16 Commercial Policy Instructions for Use ..................................................................... 16 • Gender Dysphoria Treatment
[Show full text]
Novel Surgical Techniques in Female to Male Gender Confirming Surgery
638 Review Article Novel surgical techniques in female to male gender confirming surgery Miroslav L. Djordjevic Department of Urology, School of Medicine, University of Belgrade, Belgrade, Serbia Correspondence to: Miroslav L. Djordjevic, MD, PhD. Department of Urology, School of Medicine, University of Belgrade, Tirsova 10, 11000 Belgrade, Serbia. Email: [email protected]. Abstract: The current management of female to male (FTM) gender confirmation surgery is based on the advances in neo phalloplasty, perioperative care and the knowledge of the female genital anatomy, as well as the changes that occur to this anatomy with preoperative hormonal changes in transgender population. Reconstruction of the neophallus is one of the most difficult elements in surgical treatment of female transsexuals. While there is a variety of available surgical techniques, their results are not equally acceptable to all patients. The preference for a particular surgical technique mostly depends on the patient’s desires and expectations. Nevertheless, the surgeon’s duty is to fully inform the patient about all the advantages and disadvantages, as well as all complications that might occur after surgical procedure—and even to talk them out of a desired surgical technique if there are contraindications. Metoidioplasty is a technically demanding surgical procedure used in FTM transsexuals who desire a gender reassignment surgery (GRS) without undergoing a complex, multi-staged surgical creation of an adult-sized phallus. Metoidioplasty is viable in cases where the clitoris seems large enough after androgen hormonal treatment. Since the clitoris plays the main role in female sexual satisfaction, its impact on the outcome of FTM transgender surgery is predictable.
[Show full text]
Gender Reassignment Surgery Model Ncd
GENDER REASSIGNMENT SURGERY MODEL NCD I. Indications, Limitations of Coverage and/or Medical Necessity 1 II. Documentation Requirements 4 III. Providers of Gender Reassignment Surgery 5 IV. Common CPT Codes 5 V. ICD-9 and ICD-10 Codes 8 VI. References 9 Written by Transgender Medicine Model NCD Working Group. Contact: Anand Kalra, Transgender Law Center ([email protected]). Gender Reassignment Surgery Model NCD | 1 I. Indications, Limitations of Coverage and/or Medical Necessity The purpose of this National Coverage Determination is to implement the U.S. Department of Health and Human Services Departmental Appeals Board’s 2014 decision overturning NCD 140.3 (Transsexual Surgery). The U.S. Department of Health and Human Services Departmental Appeals Board (“DAB”) considered categories of evidence as outlined in the Medicare Integrity Program Manual § 13.7.1 when it determined that the previously extant prohibition on “transsexual surgery” in NCD 140.3 was unreasonable.1 Implementing a policy to provide access to Gender Reassignment Surgery is centered in improving population health outcomes among transgender Medicare beneficiaries. The Medicare Integrity Program Manual § 13.7.1 provides that NCDs should be based on published authoritative evidence and general acceptance by the medical community. Summarized, this means treatments should follow: Evidence-based best practice derived from definitive studies such as meta-analyses, randomized clinical trials, or clinical evidence Best practice as accepted by the medical community, as supported by sound medical evidence based on: o Scientific data or research studies published in peer-reviewed medical journals; o Consensus of expert medical opinion (i.e., recognized authorities in the field); or o Medical opinion derived from consultations with medical associations or other health care experts.
[Show full text]
Trans Issues and Later Life
Factsheet 16 Trans issues and later life July 2021 About this factsheet This factsheet provides information about later life for trans people. The main focus is on growing older for people who have transitioned and live permanently in their affirmed gender. It also provides information for people in later life who are thinking about gender reassignment. The factsheet covers a range of legal, financial and social care issues. It includes a guide to terminology and details of where to go for further information and support. Terminology used by trans people to describe their experiences and identities is varied and changes over time. We are committed to reflecting this diversity but recognise that terms used in this factsheet may vary in their usage or become outdated. The information in this factsheet is applicable to England and Wales. If you are in Scotland or Northern Ireland, please contact Age Scotland or Age NI for information. Contact details are at the back of the factsheet. Age UK Advice can give you contact details for a local Age UK in England. In Wales, call Age Cymru Advice. Contact details for any organisation mentioned in this factsheet can be found in the Useful organisations section. Page 1 of 32 Contents 1 Recent developments 4 2 Who is trans? 4 3 Trans and other gender identities 5 3.1 Transsexual people 5 3.2 People who cross-dress 6 3.3 Non-binary people 6 4 Transitioning in later life 7 5 The transitioning process 7 5.1 Transition and hormones 9 5.1.1 The trans man’s transition 9 5.1.2 The trans woman’s transition
[Show full text]
Metoidioplasty As a One-Stage Phallic Reconstruction in Transmen
Bizic et al. Plast Aesthet Res 2020;7:43 Plastic and DOI: 10.20517/2347-9264.2020.80 Aesthetic Research Review Open Access Metoidioplasty as a one-stage phallic reconstruction in transmen Marta Bizic1,2, Borko Stojanovic1,2, Marko Bencic2, Noemi Bordas2,3, Miroslav Djordjevic1,2 1Department of Urology, Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia. 2Belgrade Center for Urogenital reconstructive Surgery, Belgrade 11000, Serbia. 3Department of Urology, Kiskunhalasi Semmelweis Kórház, Kiskunhalas 6400, Hungary. Correspondence to: Dr. Marta Bizic, Department of Urology, Faculty of Medicine, University of Belgrade, Tirsova 10, Belgrade 11000, Serbia. E-mail: [email protected] How to cite this article: Bizic M, Stojanovic B, Bencic M, Bordas N, Djordjevic M. Metoidioplasty as a one-stage phallic reconstruction in transmen. Plast Aesthet Res 2020;7:43. http://dx.doi.org/10.20517/2347-9264.2020.80. Received: 17 Apr 2020 First Decision: 18 May 2020 Revised: 7 Jun 2020 Accepted: 19 Jun 2020 Published: 15 Aug 2020 Academic Editors: Marlon E. Buncamper, Stan J. Monstrey Copy Editor: Cai-Hong Wang Production Editor: Jing Yu Abstract Gender dysphoria is a condition where there is a discrepancy between the gender assigned at birth and the desired gender, leading the patient to pursue surgical intervention. Reconstruction of the neophallus for transmen is still challenging, even though there are many surgical techniques with satisfying results. The aim of neophallic reconstruction in gender affirmation surgery (GAS) for transmen is to provide stand-up voiding, erotic sensation, orgasm and penetration ability, and acceptable donor site morbidity with minimal scarring and complications. Metoidioplasty as a variant of phalloplasty for transmen is a one-stage procedure that results in male-like external genitals, with minimal scarring, ability of standing micturition, and full erogenous sensation with the ability to achieve orgasm during sexual intercourse.
[Show full text]
Masculinising Hormone Information
Masculinising Hormone Information TABLE OF CONTENTS - Introduction to Hormones - Sex Hormones - Puberty - Androgen Treatment - Types of Treatment - Administration - Masculinising Hormone Effects - Risks & Side Effects - Regular Health Checks - Androgen Induced Puberty - Maximising the Benefits, Minimising the Risks Testosterone Beginning masculinising hormone treatment can often be seen as a significant step forward in the lives of those on the masculine end of the transgender spectrum. It can have such a profoundly positive impact on the quality of life of an individual and give rise to an increased level of self-esteem and inspire further positive decision making towards a better future. However the degree and rate of the physiological and psychological changes caused by masculinising hormone treatment will vary for each person, there is also is no way of knowing exactly how your body will respond until treatment has commenced. While the process of bringing one’s body and mind closer together often has many positive effects, there are also a number of side-effects and risks involved with hormone treatment. By understanding what you can realistically expect, we hope that you will become better informed and more able to engage effectively with your health care providers to maximize the benefits and minimize the potential risks. The Gender Centre provides this masculinising hormone information fact sheet specifically for people in the masculine transgender range, those that are considering taking masculinising hormones. We acknowledge that not all people will aspire to the same goals with their masculinising process, and for this reason we have aimed at providing a fact sheet that reduces assumptions and labels in this respect.
[Show full text]
Metoidioplasty Description Intended Results And
METOIDIOPLASTY Summary for Primary Care Providers | April 2019 OBJECTIVE This summary provides information to facilitate discussion of transition-related surgery between primary care providers and patients. It is not exhaustive and does not replace the informed consent process between surgeon and patient. Alberta Health has developed criteria for eligibility for funding for metoidioplasty, and the application process, found at: https://www.albertahealthservices.ca/info/Page15676.aspx. DESCRIPTION Metoidioplasty is a masculinizing gender affirming surgery whereby a neophallus is created with the enlarged clitoral tissue. Ligaments around the clitoris are cut, allowing the clitoris to develop a longer shaft similar to a penis. The urethra is extended to the tip of the penis /neo -phallus. INTENDED RESULTS AND BENEFITS Reduces gender dysphoria by aligning anatomy with gender identity Creation of a penis/neo-phallus, +/- scrotum and testicular implants To allow standing urination Greater chance of maintaining erogenous sensation in the neophallus compared to phalloplasty Less scarring than phalloplasty (e.g., no forearm scar) POTENTIAL DRAWBACKS If vaginectomy and scrotoplasty are desired, hysterectomy + BSO are also required, resulting in infertility. Neophallus is not usually large enough for insertive penetrative sex. Inability to have receptive vaginal sex if vaginectomy is performed. Risk of complications requiring additional surgical revision. While the risk of complications arising from metoidioplasty is substantial, it is much less risky than phalloplasty. These recommendations are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. They should be used as an adjunct to sound clinical decision making. Metoidioplasty – Summary for Primary Care | April 2019 SURGICAL TECHNIQUES AND OPTIONS Chronic testosterone therapy results in an enlarged clitoris.
[Show full text]