gender reassignment surgery male to female thailand

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TRANSGENDER SURGERY Gender reassignment surgery

Sex reassignment surgery (srs), penile skin inversion, scrotal skin graft, signmoid colon vaginoplasty, secondary colon vaginoplasty, labiaplasty after srs​, transgender breast surgery, breast augmentation (less than 400 cc), breast augmentation (more than 400 cc), correction breast implants, breast lift​, body surgery, liposuction, abdominoplasty (tummy tuck), gluteal implant (buttock augmentation)​, dental care, scaling and polishing, tooth whitening, facial feminization surgery (ffs), tracheal shave, brow bossing reduction, hairline lowering, upper eyelid, lower eyelid, nose reduction, cheek augmentation, osteotomy-malarplasty, chin augmentation​, chin reduction, jaw reshaving​, hair transplantation.

My name is Charee Sripaisalmongkol and I am principal consultant at Estetica Thailandia.

I found estetica thailandia as a place to assist everyone to achieve their dream. rather than an agent, i see myself as their liaison and consultant who try to understand their concerns and give them a sincere assistance. ‍ i enjoy the companionships from all of my clients. to be a part of making their dreams come true is my delight and this is what keeps me going with estetica thailandia. thank you for visiting my page and wish you the best for your beautiful future., as you begin the journey down the path of transgender surgery, you need a friend and companion who knows how it all works to help you anticipate your needs at every point. at estetica thailandia, you can count on me to walk you through each step to make this once-in-a-lifetime decision the most satisfying one for you. i am your consultant who can explain every step of the procedure to you in simple layman's terms, so that you can make an informed decision before, during and after the surgery. my utmost concern is the patient's safety, well-being and satisfaction., tag : gender reassignment surgery , sex reassignment surgery thailand , gender reassignment surgery cost thailand , sex reassignment surgery male to female , facial feminization surgery thailand , male to female surgery cost in thailand , srs results , srs thailand , srs surgery thailand , thailand srs cost , mtf surgery thailand , mtf srs results , thailand srs cost , bangkok transgender surgery , sex change thailand prices, 7 reasons you’ve found the perfect service ​, with more than 10 years’ experience focusing on gender reassignment surgery, we give you the peace of mind money can’t buy., we work with experts in the field, and are always available to pre-screen doctors so you can find someone who fulfills all your needs., our expert team understands the intricacies and personal nature of srs, and always work to minimize any post-op complications., by working closely with local clinics and doctors, we ensure you understand your options, every step of the way., when you have a question; all you have to do is ask, and we’ll ensure you get the answers you need., our comprehensive service is designed to make your life easier., we’re free to use; which means you pay exactly the same price you’d be charged if you went direct to the clinic..

You don't Pay for my Service​

         the hospital does. i am a liaison between you, the patient, and the surgeon to facilitate the sex change trip   arrangement prior to patient's arrival until patient's departure. my consulting services include the following:​.

Trip planning including hotel booking and SRS documents preparation

Srs and ffs surgery suggestion, airport transfer by our liaison, interpretation during pre & post operative consultation with doctor, 24/7 assistance on call in case of emergency, answering to all pre-post operative questions, budget control assistance.

10 years experience with SRS consultancy​

         sex change surgery has more complicated procedures than any other kind of surgery. the preparation before and after the surgery can be hard in some cases i.e. srs document preparation and submission, postoperative care, etc. having worked with many srs cases, i am  highly experienced;    therefore, i can professionally assist you through your srs journey.​.

You Pay Direct to the Hospital, without any Markup​

I am the affiliated agency of srs & ffs clinics and fully funded by the hospital; therefore, i offer the above consulting services to you at no additional cost on your medical bill. you will pay directly to the hospital or clinic, not to me, without any mark-up price. this means that you will receive the free-of-charge medical      consulting service from me if you choose to contact the doctor and hospital through estetica thailandia.​.

Why are my services perfect for you?​

Excellent service​, my services are unique and created with passion. i work closely with patients and treat them as partner in this  venture. i provide friendly assistance in all medical facets of the trip. my experienced and attentive liaisons will assist you to assure that you receive a desirable treatment with the most satisfying result. more than a liaison between patient and hospital, i am your "friends and   confidante" who will stand by you and hold your hand through this challenging moment of your life..

June 28, 2023

Understanding the Importance of Pre-operative Genital Hair Removal for MtF Gender Reassignment Surgery

As a provider who frequently receives questions from clients about the necessity of pre-operative genital hair removal for male-to-female (mtf) sex reassignment surgery, i want to address this topic in a friendly and informative way. let's dive into the details together and explore why this aspect is significant for your journey.

August 04, 2020

Facial Feminization Surgery (FFS) in Thailand with Estetica Thailandia​

Facial feminization surgery, referred to as facial gender confirmation surgery (fgcs) and facial harmonization surgery, is, to explain in short, a group of combined maxillofacial and plastic surgery techniques used to reduce masculine facial features and give the face a softer and more feminine look. there is no specific type of ffs for each patient nor one size fits all set of procedures used in facial feminization, your srs trip to thailand: getting ready for it​, after booking the sex reassignment surgery with us, it is hard for the first timers to imagine how the trip’s going to be. as a medical tourist, the activities, well-beings and visits to sights in bangkok are, of course, different from other kinds of tourism, transgender surgery​.

© 2022 Estetica Thailandia. All Right Reserved.​​

Bariatric Surgery

Body Procedures

Breast Procedures

Dental Surgery Procedures

Facial Procedures

Gender Reassignment Surgery Overseas

Scar Revision

• Buttock Augmentation
• Designer Vagina
• Liposuction
• Breast Implants
• Breast Lift
• Breast Reduction
• Brow or Forehead Lift
• Ear Pinning (Otoplasty)
• Eye Lift (Blepharoplasty)
• Rhinoplasty (Nose Surgery)
• Face Lift Package - Kuala Lumpur

Destinations

• Kuala Lumpur, Malaysia
• Pattaya, Thailand
• Phuket, Thailand
• Senawang, Malaysia
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• Novotel - Kuala Lumpur
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• Crest Resort and Pool Villas - Phuket
• Andakira Hotel - Phuket
• Ocean Front Beach Resort - Phuket
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• Beverly Wilshire Medical Centre
• Imperial Dental Specialist Centre
• Bangkok Hospital Pattaya
• Phuket Plastic Surgery Institute (PPSI)
• Selam Senawang Specialist Hospital
• Dr. Poonsak
• Dr. Teerasut
• Dr. Piyapas
• Dr. Parinya
• Dr. Sanguan
• Dr. Veerawat
• Client Reviews
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• The Process
• 15 - 30% Off Multiple Procedures - Kuala Lumpur
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GENDER REASSIGNMENT SURGERY Overseas

Also commonly called Sex Reassignment Surgery (SRS), this procedure helps individuals become the person they want to be by transitioning them into the gender they associate with. It is becoming a very common procedure with more and more individuals taking the next step in their transition. At the moment we offer male to female transition only.

INDIVIDUAL HOSPITAL PRICING IS LISTED FURTHER DOWN THE PAGE

If you would like to obtain a personalised quote for Gender Reassignment Surgery Overseas, please refer to our Enquiry page.

Procedure Pricing

Beverly Wilshire Medical Centre +

Phuket Plastic Surgery Institute (PPSI) +

Phyathai 2 Hospital +

Yanhee International Hospital +

What you need to know

BEST CANDIDATES +

The best candidate for Gender Reassignment Surgery (GRS) is someone who is:

• unhappy with the gender they are and wish to become the gender they associate with
• fully aware that this is a permanent procedure
• aware of all of the steps involved
• aware of any legalities that are required in their country for changing their name, gender etc

Because this is significant, life-changing surgery, it is important that you are physically, mentally and emotionally ready. As with any cosmetic surgery procedure, it is imperative you speak to someone you trust, are happy in your life and are psychologically ready.

PREPARING FOR YOUR PROCEDURE +

It is important to discuss with your doctors and with us any:

• Medical conditions you have
• Any medication you are taking - prescription, herbal and non-prescription

Once you arrive at your destination you will have a physical evaluation with your surgeon, where you will discuss your goals and concerns and finalise the plan for surgery. At this examination your surgeon will determine the best procedure for you and explain it to you in detail, including any limitations. It is important that you head into surgery with realistic goals. It is during this examination that your surgeon may also make recommendations for other procedures. 

In the lead-up to your surgery, it is important you do the following:

Stop smoking. Smoking can cause problems with circulation and increase the possibility of complications.

What does gender reassignment surgery include?

The process of sex reassignment surgery (SRS) is to help people transition into the gender they align themselves with. There are various procedures, some of which can be done at the same time and some that must be staggered for medical purposes. There is female to male transitioning, but we currently only offer male-to-female transitioning. The five common procedures Beautiful You Holidays offers are; Orchiectomy, Penectomy, Vaginoplasty, Facial Feminisation and Body Contouring (including breast augmentation). 

At what age can you change your gender?

In New Zealand, the minimum age for considering gender reassignment surgery is currently adults over 18 years of age. Anyone under this minimum age is not legally entitled to undergo any of the procedures above, even with the consent of an adult.

Can you reverse gender reassignment surgery?

The decision to undergo SRS isn’t one to be taken lightly. We ensure candidates understand the steps and legalities involved, and that patients understand that this is a permanent procedure. In the extremely rare case that someone who has undergone gender reassignment surgery wants to reverse the surgery, please consult a doctor. 

WHAT TO EXPECT +

Surgical Procedures:

There are several procedures involved with a male to female gender reassignment, some of which can be performed at the same time. How many procedures you have done at the same time will depend on your own wishes along with the recommendations of your surgeon.

Orchiectomy (removal of the testicles)

An orchiectomy is a quick procedure and is often performed as part of a more comprehensive reassignment process. It is imperative to understand that without testicles the male hormone testosterone will not be produced. 

Penectomy (removal of the penis)

This procedure can be performed as a single procedure or as part of the gender reassignment process should you want to create female genitals. During the penectomy, the urethra will be shortened and redirected. 

Vaginoplasty (creating a vagina)

A vaginoplasty is used to create a vagina and is often done by using the skin of the penis and turning it inside out to create the walls of the vagina. The specifics depend on the size of the penis and the surgeon's techniques. During this procedure, it is also common to alter the urethra by is shortening and repositioning it so that it functions as it would in a female body.

A vaginoplasty is done to improve the function of the body part and should not be confused with labiaplasty, which is more of an aesthetic change. While performing a vaginoplasty, it is common to include a labiaplasty and clitoroplasty to create female genitals that are aesthetic, minimally scarred, and sensitive to sexual arousal.

Facial Feminisation  

The techniques used to feminise a face vary based on the client’s facial structure and features, with the following procedures used:

• Face lift 
• Otoplasty (ear pinning)
• Rhinoplasty (nose surgery)
• Tracheal shave (reducing the size of the Adam’s Apple)

Body Contouring

The techniques used vary from client to client, with the following procedures used:

• Tummy tuck 
• Breast augmentation
• Buttock implant 

LENGTH OF SURGERY +

The length of surgery depends on the procedures performed, your body and your surgeon’s recommendations. It is common to stay in the hospital for 14 nights. 

Recovery and post-op care:

While your recovery will depend on the procedures performed, it is common to experience pain and discomfort following the surgery, which will be managed by painkillers prescribed by your surgeon.

Your surgeon will give you instructions on how to perform periodic dilation (stretching the vagina walls). You will be given a dilator to wear inside the vagina to ensure it does not close over or change in shape. It is common to do this for eight weeks following your vaginoplasty, with the frequency gradually reducing. The vagina should be cleaned regularly as per your surgeon’s specific instructions.

You will be able to return to light work 4 to 6 weeks after surgery, and slowly being more strenuous work and exercise around 6 to 8 weeks after surgery.

Length of stay:

Most surgeons recommend staying on holiday for at least 21 days, during which time you will have regular follow-up appointments with your surgeon. To get the most out of your recovery time we suggest you partake in gentle exercise, yoga classes and treat yourself to some pampering. If you are feeling up to it, there is plenty to see and do in Phuket, Bangkok and Kuala Lumpur.

PRECONDITIONS AND RISKS +

Risks and complications are minimised by using the care and services of our highly-skilled, trusted doctors and nurses. However, with every precaution taken complications can still occur. These are rare and few patients experience any issues. If you have any concerns about your procedure and the possible preconditions and risks, please discuss them with your doctor and nurses.

Potential risks include:

• Hematoma (which can be treated either through puncture or surgery, depending on the size)
• Nipple necrosis (which can be corrected with aesthetic procedures to reconstruct the nipples should this happen)

OTHER PROCEDURES TO CONSIDER +

If you would like to take advantage of your time away, there are other non-surgical procedures you can add so you return home feeling refreshed. These include cosmetic fillers, laser resurfacing and chemical peels.

Got a question? Talk to our friendly team

"Overall my experience with Beautiful You Holidays was awesome. Each surgeon will go above and beyond to exceed your needs. The best decision I have ever made in my life."

Indulge in a beauty holiday today

Because looking great has never been this easy.

or find out more by filling out our enquiry form

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Terms and Conditions

Male to Female Gender Affirmation Surgery

Male to Female Gender Affirmation Surgery (Sex Reassignment Surgery) involves remodeling the male genitals into a form with the appearance of, and the function of female genitalia.

The Medical Council of Thailand defines “Gender Affirmation Surgery (Sex Reassignment Surgery)” as surgical techniques conducted to change the gender of a patient from male to female or female to male, including the use of hormones from one gender to the other.

A simpler explanation is that it is a surgical procedure in which the patient’s sex organs are altered as well as function to satisfy their desires.

Male to female gender affirmation surgery, then, is surgery that involves transforming the male genitalia into the female genitalia, which comprises the following procedures:

• Creation of the External Female Genitalia (vulva)
• Design of the New Vagina (neovagina)

In most cases, your surgeon performs sex reassignment surgery during the last phase of the transgender process.

Transgender reassignment is a complex process that begins with the patient living in the gender they desire for some time, taking hormones to achieve the necessary physical changes, and undergoing surgery on other bodily parts, such as the breasts and genitals.

Gender affirmation surgery is a delicate and complex type of surgery and, once done, cannot be easily reversed. The primary purpose is to fulfill psychological and physical needs.

Patients who wish to undergo this surgery must first meet the World Professional Association for Transgender Health (WPATH) criteria. This criterion ensures that the individual will live happily with the new gender they desire to be transformed to after the procedure and minimize the possibility of making a significant “Wrong Decision” and regretting it for the rest of their life.

Not all transgender people undergo SRS. Those who do have SRS for a variety of reasons.

Some people use it to alleviate bodily dysphoria — intense discomfort caused by a mismatch between identity and body.

Others are comfortable with their bodies but are incredibly uncomfortable with how others see them (social dysphoria) and wish to alter their physical appearance to live a life more consistent with their identity.

Choosing surgery for any health problem is a significant decision, and Sexual Reassignment Surgery is no exception.

This guide’s objective is to:

• describe MTF-SRS alternatives,
• identify potential risks and consequences associated with MTF-SRS,
• detail what to expect before and after MTF-SRS, and
• explore factors to consider when deciding to have SRS.

MTF patients who are considering SRS will find this guide very helpful. It may also benefit partners, family members, and others curious about SRS.

• Surgical Procedures for MTFs
• Breast Augmentation Surgery
• Procedures of the Face & Neck
• Genital Surgery

SRS’s goals for MTFs are to diminish “male” traits and make the body appear more “feminine.”

MTF SRS may entail some or all of the following surgeries. These surgical procedures carry risks but have improved the quality of life for MTFs experiencing physical or social dysphoria.

Breast surgery, facial surgery, and genital surgery are all addressed in length here. In addition, you can read about voice change surgery here.

Estrogen causes breasts and nipples to grow, but there is a limit to how much breasts can grow on their own.

MTFs who want larger breasts or a change in breast shape can have implants inserted through an incision under the breast, armpit, or around the nipple.

What will the appearance and feel of my breasts be like after implants?

Surgically augmented breasts typically look and feel different than non-implanted breasts. For example, augmented breasts are generally wider, firmer, and rounder than naturally developed breasts.

This difference is especially true for MTFs or non-trans women who get implants later in life because their breasts have not gone through the age-related process seen in non-trans women without implants (the skin stretches and the breasts droop as we get older).

Furthermore, MTFs frequently have larger chest muscles and a broader chest than non-trans women.

Working with a surgeon who understands how MTF skin, muscle shape, and breast development differs from that of non-trans women can be beneficial in deciding on an implant shape and technique that will produce the desired result.

Viewing photos of MTFs who have had breast implants can give you an idea of what to expect. You can also request that surgeons show you before and after pictures of their patients.

Materials used to make breast implants.

Most breast implants are made of saline (saltwater) or silicone.

A word of caution regarding silicone injections

Semi-solid implants are used for breast augmentation, with the liquid filler surrounded by a solid shell that keeps the fill contained. Some MTFs who cannot afford surgery have attempted to augment their breasts, hips, cheeks, lips, or buttocks by purchasing liquid silicone and injecting it themselves or having an injection performed by a friend or unlicensed health worker.

Injection of liquid silicone (also known as “free silicone”) is extremely dangerous and, as a result, is not permitted as a medical procedure.

There are serious health risks associated with liquid silicone, including permanent disfigurement, lung disease, brain damage, and death.

If you have ever received a liquid silicone injection, you should consult a doctor as soon as possible.

When deciding whether or not to get breast implants, it is essential to keep in mind that all types of breast implants frequently leak or rupture and must be removed.

Breast implants are not considered lifetime devices. Therefore, you will almost certainly require additional surgeries and visits to your surgeon in the future.

Your implants will almost certainly have to be removed at some point, and you will have to decide whether or not to replace them.

Implants stretch the skin. If implants are removed but not replaced, your skin will be wrinkled, dimpled, or puckered.

Breast augmentation timing

In some MTFs, estrogen can significantly alter breast size and shape. While breast growth begins soon after beginning estrogen therapy, it is slow and gradual, and it typically takes two or more years for breasts to reach their maximum size.

If you can take hormones, it is recommended that you wait at least 18 months to allow your breasts to develop.

Hormonal development will aid in the growth of your nipples and the stretching of your chest skin, resulting in a more natural-looking implant.

Instead of being implanted into a flat chest, implants look more natural when augmenting existing breasts.

Some MTFs are unable to take hormones due to medical reasons, do not want the side effects of hormones, or enjoy breasts without the other effects of hormones. If you are unable to take hormones, implants may be an option.

Breast surgery can be performed as the first (or only) step in surgery or after you’ve had other types of SRS (e.g., genital surgery).

What to Expect Before and Following Breast Augmentation

In a hospital.

You will come to the hospital on the day of your surgery to review pre-surgery information and have a last-minute physical exam.

You will be instructed not to eat or drink after midnight the night before surgery.

After your surgery, hospital personnel will monitor you as you awaken from anesthesia.

You will most likely be given antibiotics to help reduce the risk of infection while your wounds heal in the hospital.

Following breast surgery

You will be required to wear a special bra and leave the surgical dressings on for as long as the surgeon requires.

Your surgeon or nurse will determine the right time for you to take a shower.

It is usual for the incisions to be red, but the redness should not extend beyond the incision for more than 1–2 cm (if this occurs, see a doctor immediately because it could be a sign of infection).

It is also customary to see or feel the knot in the stitches at the incision’s end. But, again, the stitch knot is not a problem; it will either dissolve on its own or come to the surface of your skin, where it can be clipped free by a doctor or nurse.

A moderate amount of bruising and swelling is expected. Your breasts will most likely be sore and swollen for at least a month following surgery. Consult a doctor if you have a lot of swelling. During the healing process, sharp shooting pain, burning pain, or general discomfort are expected and eventually subside.

Severe discomfort usually subsides 1–2 days after surgery.

You can resume your routine when you feel well enough to do so (i.e., regular movements do not cause pain). This usually takes 1–2 weeks, but it can take longer in some cases.

For the next 3–4 weeks, avoid any activity that causes your heart rate to rise.

Breast implant dangers and potential complications

Any surgery requiring general anesthesia is a serious medical procedure. There is a risk of blood clots (which can be fatal) or an adverse reaction to the anesthetic with any surgery.

Surgeons, anesthetists, and surgical nurses have extensive experience preventing problems and responding to emergencies during surgery. To avoid blood clots after being discharged from the hospital, move around as much as you feel comfortable and drink plenty of water.

Obtain immediate medical attention if you experience sudden shortness of breath, chest pain, dizziness, or tender, warm, and swollen legs. You may have a blood clot and require immediate medical attention.

Aside from the risks of blood clots, every surgery carries the risk of infection, bleeding, pain, and thick red scars. Antibiotics are commonly administered in hospitals to reduce the risk of infection.

It is usual for the breasts to be sore and the incision line to be red after surgery. If the redness extends more than 1–2 cm beyond the incision, the skin is tender or warm, and you don’t feel well, see a doctor to rule out an infection.

The following are some of the potential complications associated with breast implants:

• Capsular contracture: thickening and contraction of scar tissue that forms naturally around the implant (some scar tissue is okay; an excess can be problematic).
• Lopsided breast size, shape, or position (one side appears larger or smaller than the other)
• Asymmetrical placement of the nipple (one side looks higher than the other)
• Rippling of the skin over the implant is more likely if you are thin or your breasts haven’t appropriately developed after hormone therapy.
• Implant problem: leakage, rupture, infection, or implant coming out of the body Change in sensation to nipples/breast skin: less or more intense feeling.

You will almost certainly require additional surgery if:

• there are implant problems: the surgeon will have to remove your implant but can replace it later
• your breasts or nipples are lopsided: the surgeon will wait 4–6 months after surgery to see how the implant settles
• you have severe capsular contracture (the scar tissue is making your breasts excessively firm, distorting their shape, or causing you pain)

During puberty, testosterone causes numerous changes in MTF bodies, including the formation of skull and face bones and cartilage in the face and neck.

Although hormone therapy can soften the skin of the face and cause minor changes in the fat/muscle structure of the face after puberty, hormones cannot change the basic structure of the face and neck; only surgery can reshape the contours of bone and cartilage.

MTFs have varying perspectives on face and neck surgery. Some believe it is critical in reducing gender dysphoria and enhancing passability.

Others are concerned that MTFs may feel pressured to undergo face and neck surgery to meet conventional standards of female attractiveness.

There is no right or wrong answer regarding whether to have a face or neck surgery, as with any other type of SRS: it is a personal decision.

Tracheal shave

In the throat/neck, cartilage rings surround the windpipe. The thyroid cartilage juts forward more pronouncedly in “males” than in “females.”

This point is also known as the “Adam’s apple” or the laryngeal prominence.

The thyroid cartilage can be surgically altered (“tracheal shave” or chondrolaryngoplasty) to reduce the size and visibility of the laryngeal prominence.

This surgery can be done concurrently or separately from voice surgery.

Facial feminization surgery (FFS)

FFS techniques are divided into surgery into the bones or cartilages of the skull and work on the soft tissue that covers the bone/cartilage.

The differences between the average “male” and “female” skulls are used to reconstruct bones in FFS. In addition, soft tissue work may be performed to supplement or replace bone reconstruction if only minor changes are desired.

Soft tissue surgery is less invasive than bone surgery.

FFS can include surgical modifications to any of the following areas:

Based on three differences in the facial structure of non-trans women and men, FFS creator Douglas Ousterhout emphasizes the surgical change of the forehead as a crucial part of facial “feminization”:

• As shown in the image below, “male” skulls have a relatively flat slope from the hairline to the brows, whereas “female” skulls are more curved.
• As shown in the image below, “males” have a thicker bony ridge just above the eyes (brow bossing).
• “Males” have a longer distance between their brows and their hairline than “females,” even if they do not have “male”- pattern baldness (which further increases this distance).

The following surgical changes to the forehead can be performed as part of FFS:

• Brow shave: removing brow bossing by grinding down the orbital rims (upper edge of eye sockets).
• forehead implant: using synthetic bone-filler to round out a flat forehead;
• brow lift: tightening of the skin on the brows and raising of the brows
• hairline and scalp advancement: bringing the hairline and scalp forward

Surgical Procedures of the Chin and Jaws

FFS creator Douglas Ousterhout describes three differences in the structure of non-trans women’s and men’s chins and jaws:

• As shown in the image below, “male” chins are broader and squarer, whereas “female” chins are pointed and narrower.
• The distance between the bottom lip and the base of the chin is shorter in “females” than in “males.”
• “Male” jaws have fuller back corners, with the bone having a sharper angle and flaring out away from the face and a more prominent masseter (chewing) muscle.

Female jaws have a gradual curve from the ear to the chin, with a less square and full shape in the back.

The chin and jaw FFS is performed through the mouth and incisions around the lower gums.

The following surgical changes to the chin and jaw can be performed as part of FFS:

• removing bone from the back corner of the jaw to make it less prominent;
• removing bone from the chin and reshaping it to look more tapered, less square, and shorter;
• using implants if the chin is receding;
• liposuction under the chin to make the lower part of the face appear less heavy;

Rhinoplasty is the surgical procedure used to alter the appearance of the nose. Some MTFs want to change the appearance of their nostrils or the tip of their nose.

Other times, MTFs who have forehead surgery will be advised to have surgery on the nose bridge so that the flow from nose to forehead appears smooth.

Among the nose changes that can be made as part of FFS are:

• removing bone from the bridge of the nose to make it flatter;
• removing width from the nose to make it thinner;
• shortening the nose by removing some cartilage at the tip of the nose; and narrowing the nostrils

Cheek augmentation can be performed to highlight the “cheekbones” (zygomatic arch), making the cheeks more prominent and the chin/jaw appear smaller.

Bone grafts, synthetic implants, and fat implants can all be used for augmentation.

Among the lip surgical changes that can be performed as part of FFS are:

• removing skin from the area between the nose and the top lip to raise the upper lip
• using implants to make the lips appear fuller

Face/neck surgery timing

Most FFS techniques can be performed at any point in the transition (at the beginning, middle, or end of the process).

If you want both forehead and nose surgery, it is best to have them done simultaneously because changes to the forehead can affect the shape of the nose.

Multiple surgeries close together are generally not recommended because they put a lot of strain on your body.

What to Expect Before and Following Face/Neck Surgery

If you have electrolysis to help remove facial hair, you must stop it at least two weeks before having face surgery.

If you are having chin or jaw surgery, you will not be able to resume electrolysis for at least three months.

Talk with your surgeon about ways to temporarily remove facial hair before and after surgery as part of your pre-surgery planning.

In the hospital

You may be asked to come to the hospital on the day of the surgery to review pre-surgery information and have a last-minute physical exam. In addition, you will be instructed not to eat or drink after midnight the night before surgery.

What to expect immediately following surgery is determined by whether a local or general anesthetic was used.

Minor procedures are typically performed under local anesthetic (similar to having a tooth drilled), and you can return home shortly afterward. However, a general anesthetic is usually required for bone reconstruction or tracheal shave.

If you have a general anesthetic, hospital staff will monitor you as you awaken. For minor procedures, you will be sent home the same day as surgery with pain medication; for more extensive procedures, you will be admitted to the hospital for the night.

You will need to have someone drive you to your hotel or take a taxi when you are discharged because it is unsafe to drive right after surgery.

You will be given antibiotics to help reduce the risk of infection as your wounds heal in the hospital.

Following surgery

The aftercare instructions differ depending on the type of facial surgery and the technique used. Discuss pain management options with your surgeon before surgery to ensure you understand what to expect and what you need to do after being discharged from the hospital.

Dr. Douglas Ousterhout, the creator of FFS, provided the following information:

• The surgeon usually removes sutures and staples used to close scalp incisions within eight days of surgery. Most people feel well enough to return to work by this point (though vigorous activity should be avoided for the first two weeks after surgery).
• Within 10–12 days of surgery: Swelling and bruising around the eyes usually resolve by this time.
• Within two weeks of surgery: Swelling should have subsided by this point.
• For the first 1–2 days after surgery, internal nasal packing will be left to support nasal tissues during the healing process.
• Bruising around the nose and eyes usually fades within two weeks of surgery.
• One month after surgery: It is safe to resume strenuous activity. You can continue wearing your glasses as usual.
• You can usually return to light work 5–6 days after surgery.
• The face is usually moderately swollen and bruised after surgery.
• Jaw reduction: Pain medication will be prescribed. Most of the swelling fades gradually over 10–14 weeks, but it can be difficult to see improvement until the swelling has completely subsided. You can usually return to work 10–14 days after surgery.
• Lip augmentation: This is usually a minor procedure. Swelling may occur, but it usually subsides within 10–14 days of surgery.

Face/neck surgery risks and potential complications

Every surgery carries the risk of infection, bleeding, pain, and the formation of thick red scars. Antibiotics are commonly administered in hospital to reduce the risk of infection.

It is usual for swelling and bruising to occur after facial surgery. If your skin is very tender or warm, and you are not feeling well, consult a doctor to determine whether you have an infection.

Any surgery requiring general anesthesia is a serious medical procedure. There is a risk of an adverse reaction to general anesthesia or, if you are lying flat for an extended period, of blood clots (which can be fatal). However, surgeons, anesthetists, and surgical nurses have extensive experience preventing problems and responding to emergencies during surgery.

To avoid blood clots after being discharged from the hospital, move around as much as you feel comfortable and drink plenty of water. If you experience sudden shortness of breath, chest pain, dizziness, or tender, warm, and swollen legs, seek emergency medical attention. These symptoms may indicate a blood clot, and you may require immediate medical attention.

The following are some of the risks associated with face/neck surgery:

• numbness, pain, or difficulty controlling the muscles of the operated-on area: this can be temporary (due to swelling) or permanent (from nerve damage)
• Implant, wire, or screw issue: infection, reabsorption, or coming out of the body
• tracheal shave: possible voice damage
• difficulty adjusting to looking different after surgery (some people describe this as feeling like a stranger is looking back at them when they look in the mirror)
• Disappointment with the appearance of results: eyebrows raised too high, the nose looks unnatural, etc.

Preparation for Genital Surgery at Yanhee hospital

Preparing for Genital Surgery begins with the physician taking a medical history, assessing the patient’s desire to be transgender, and reviewing the transgender procedures done previously.

The doctor will then perform a complete physical examination of the patient and assess if the individual is ready for the surgery according to the following assessment criteria:

• If you are under the age of 18 years, you are ineligible to have surgery. If you are over the age of 18 but under the age of 20, you must submit consent signed by your legal guardians.
• The patient must have undergone psychiatric evaluation from 2 psychiatrists and been diagnosed as having “Gender Dysphoria,” to be written by both psychiatrists in two separate medical certificates.
• The patient must have no underlying physical or psychiatric diseases that will pose potential threats or dangers to the patient when going through anesthesia or the major surgical procedure.
• The patient must have gone through hormonal replacement therapy for at least one year.
• The patient must have lived in the opposite gender for at least one year.

After that, the doctor will perform a complete physical examination on the patient, perform blood tests, and do an x-ray. If abnormalities or congenital diseases are detected, the patient will consult with corresponding specialists to participate in the assessment.

A patient must stop taking medicines or supplements which may increase bleeding tendencies, such as aspirin, clopidogrel, herbs like cordyceps, ginkgo, ginseng, garlic, cod liver oil, collagen, and vitamin E at least two weeks before the surgery.

The patient must refrain from taking the hormones for replacement therapy for at least a month before surgery to prevent deep venous thrombosis as a postoperative complication.

Patients who smoke or use products containing nicotine, such as e-cigarettes, nicotine gum, or the nicotine patch, must discontinue using these for at least two months before and after surgery because nicotine slows down the healing process of the surgical wound.

Patients taking alcoholic beverages should refrain from taking these a week before the surgery. In addition, patients should eat soft food with less dietary fiber a week before surgery to avoid the accumulation of much residue in the intestines and leave it cleaner and more ready for the surgery.

Proper genital hygiene must be done by regularly washing well with soap and water.

Patients’ diseases or conditions that require more intensive examination or correction before sex-change surgery can be done:

• Congenital diseases or congenital disabilities that affect body functions such as heart, lung, liver, or severe kidney diseases
• Chronic diseases that are in the process of treatment, such as cancer, Systemic Lupus Erythematosus (SLE)
• HIV, Hepatitis B, and Hepatitis C
• Reproductive disorders such as phimosis and paraphimosis, hypospadias, cryptorchidism, lumps or tumors of the sexual organ, or a history of introducing foreign substances into the sexual organ, etc.
• Inguinal and abdominal hernias

Diseases or conditions in patients that will disqualify them from undergoing Sex Change Surgery:

• Congenital diseases that are not completely treated
• Unstable patients with psychiatric disorders
• Patients using illegal narcotics

Techniques for Male to Female Gender Affirmation Surgery

Male to female gender affirmation surgery (sex change surgery) is divided into two major types according to the technique used to create the vagina:

• Graft Technique (Penile Skin Inversion Technique)
• Techniques that use tissue from the abdomen, including Colon Vaginoplasty Technique and Peritoneal Vaginoplasty Technique

The Graft Technique means sex change surgery using the same genital skin to create a new vagina. This method does not require abdominal surgery and can avoid scarring around the abdomen.

The depth of the vagina depends mainly on the natural anatomy of the patient’s pelvis. However, on average, the vaginal depth is 5.5-6 inches.

The graft technique is the standard method used for the first sex-change surgery, is not very complicated, and does not put the patient at high risk. However, after the surgery, the new vagina must be taken care of by regularly dilating the vagina, especially during the first year.

The graft technique is used to create a complete external female genitalia, including the clitoris, clitoral hood and frenulum, labia majora, labia minora, and urethral orifice. It can also keep the sensory nerves in different strategic points entirely.

Suppose the patient has less genital skin, which may not be enough to perform the graft method, but does not want to undergo abdominal surgery. In that case, he may still choose the graft method using skin from other areas, such as from the groin or thigh, but the disadvantage is that there will be additional scars in those areas.

Advantages-Disadvantages of Graft Technique Sex Change Surgery

Advantages:

• Able to create a complete external genitalia
• Create a vagina that is deep and functional
• No abdominal surgery is required

Disadvantages:

• The vagina can be constricted or shallower if not adequately and adequately dilated.
• No lubricant inside the vagina
• There may be additional scars if graft from the other areas is used.

Colon Vaginoplasty Technique

The Colon Vaginoplasty Technique requires abdominal surgery, and the colon is used to create a vagina. This method has the advantage of creating a deeper, more durable vagina without any constriction.

However, the “vulvar entrance” area may still be constricted or narrowed due to the contraction of the wound. Therefore, the transgender patient who underwent this method still has to dilate the vagina to prevent narrowing at the area of the vaginal entrance.

The Colon Vaginoplasty Technique is often used in corrective surgery to increase vaginal depth. It may also be done as the first surgery if the patient has less genital skin. The appearance of the external genitalia is the same as that of the graft method in all aspects.

The walls of the vagina formed from the colon have mucous membranes that look sticky and stagnant inside so that the entrance area is often dry.

Consequently, doctors recommend that patients use lubricants each time they engage in sexual intercourse to prevent abrasions due to excessive friction.

Patients who have had recto-sigmoid vaginoplasty sex change will need more long-term self-care than those using the other surgical techniques. In addition, patients must have regular follow-up visits to the doctor.

The patient must monitor the patency of the entrance and see that it is always open so that the mucus can be drained. Otherwise, the neovaginal closed-loop obstruction may occur. If patients want to be examined or screened for colon cancer by colonoscopy, an endoscopic examination of the internal aspect of the vagina will also be required.

In addition, intra-abdominal surgery may create an adhesion band, which may later cause abdominal pain.

Advantages-Disadvantages of Colon Vaginoplasty Technique

• The vagina is deep and has strong durability.
• Creates a mucous membrane inside the vagina
• Able to develop a complete external genitalia
• Entails abdominal surgery where the colon is cut and sutured
• The entrance to the vagina created may be constricted if the dilation is not good.
• There is a chance of the patient’s developing various colonic diseases such as colon cancer and inflammatory bowel disease.
• May develop peritoneal adhesions due to intra-abdominal surgery.
• It creates a scar on the abdomen.

Penile-Peritoneal Vaginoplasty technique (PPV)

The PPV technique entails abdominal surgery, but it will use the peritoneum to create a new vagina (not the colon). This technique is often used for reconstructive surgery but can also be done as a first surgery if the patient does not have enough genital skin for grafting.

The peritoneum can produce a lubricant which is a clear yellow liquid.

However, the entrance to the vagina is still made of skin so that it can be dry and prone to abrasions as well. Hence, the doctor always recommends using a lubricant each time the patient engages in sexual intercourse.

The characteristics of the external genitalia created through peritoneal surgery are the same as those made through the grafting and bowel technique in all aspects.

Pros-Cons of the PPV Technique

• The vagina is deeper than that created through the grafting technique.
• Lubrication present inside the vagina
• Creates a complete and functional external genitalia
• Entails abdominal surgery
• If not dilated well enough, the peritoneal junction at the entrance may be constricted.
• Peritoneal tissues may form adhesions due to abdominal surgery.
• There will be scar formation on the abdomen.

How deep will the vagina be after gender affirmation surgery?

Gender Affirmation Surgery can create a vagina with a depth equal to its usual depth in a patient’s pelvis, about 5.5 – 6 inches. However, the vagina created may be deeper by about 1-2 inches more, depending on where the surgery was done using the PPV technique.

Will the new genitals have sensation?

The surgeon will collect sensory nerves to build a new genitalia sensation spot which consists of the clitoris, inner labia, and around the urethra, all of which can be capable of external sexual stimulation. The internal aspect of the vagina will not have direct sensory nerves. However, the patient may still feel sexual pleasure by external stimulation around the prostate gland area in some cases.

Recovery Time for each Surgical Technique

The Grafting Technique

• The patient will stay in the hospital for a total of 9 days.
• The doctor will not allow the patient to get off the bed for the first three days after the surgery, will only allow him to eat soft meals, and will see to it that the wound is covered with two layers of gauze urinary catheter and drainage.
• During the 4th day after surgery, the doctor will remove the outer layers of gauze and allow the patient to get off the bed.
• During the 7th day after surgery, the doctor will remove the remaining gauze, the urinary catheter, and drainage and give the patient instructions about vaginal dilation. The patient will then be discharged from the hospital if no complications are encountered.
• After surgery, the patient should rest for about one month to recover from all the inconvenient movements. Vaginal dilation has to be performed every day.

The Colon and PPV techniques

•  For the colon and PPV techniques, the patient has to stay in the hospital for 9 days. The doctor will remove all gauzes, urinary catheter, and drainage on the 4th day and give the patient instructions on dilating the vagina. The patient will be discharged from the hospital if no complications are encountered.
• The patient should rest for full recovery after sex reassignment surgery with the colon and PPV technique, for about one month if it is the first operation and for about two weeks if it is reconstructive surgery.

Postoperative care

External Wound Care

There are two kinds of medications for external use to be used for dressing:

• Povidone Iodine Solution – to be applied over the wound around the outer labia
• Povidone Iodine Gel – to be applied over the wound around the inner labia and around the urethra

Always dress the wound using these two medications for external use after urination and vaginal dilation. In addition, the patient has to wear sanitary napkins to absorb any bloodstains. Usually, the surgical wound will be healed within 2-3 weeks without post-surgical complications.

Vaginal Care

The patient must use the douching method after performing vaginal dilation by mixing the saline solution with Povidone Iodine Solution with a 1:10 ration (Ex. Saline 100 cc. with Povidone Iodine Solution 10 cc) and douche for 100-200 cc. at a time.

Postoperative Instructions

Do not squat or spread the legs before the surgical wound is completely healed, as activities like these may cause surgical wound dehiscence. Also, do not use soap and water for douching the vagina as these may irritate.

The doctor will usually allow the patient to engage in sexual intercourse after the surgery (if the wound in the vagina is already completely healed). However, an unpleasant vaginal odor may be present during the first 3-6 months due to the residual bloodstains.

The patient must avoid sour or fermented food because it may cause the surgical wound area to swell for a long time.

Information/Instructions about Vaginal Dilation

• Vaginal dilation is essential, especially during the first year after surgery, due to the wound healing process, which causes the contraction of the vagina (contraction can occur in whatever surgical technique is used). Contraction is more intense during the first year after surgery but will gradually decrease after one year.
• The patient should use the rigid dilators properly prepared by the doctor. The patient should perform vaginal dilation two times a day for 30-60 minutes per session, increasing the size of dilators according to the doctor’s instructions during the first year after surgery. After one year, the patient should perform vaginal dilation once a week, using the dilator with the biggest size.
• For additional vaginal dilation, the patient is instructed to insert a soft silicone dilator into the patient’s vagina before she goes to sleep. The patient must also wear panties to prevent the soft silicone dilator from slipping out.

Information by: Dr.Worapon Rattanalert

Frequently asked questions (MTF)

Q: In the Transgender by Penile Peritoneal Vaginoplasty (PPV) technique, lubrication is like in the vagina. Is there no need to use a lubricating gel when having sexual intercourse?

A: The entrance to the vulva is still a graft (skin), so it tends to be dry. Lubricants are still recommended every time you engage in sexual intercourse to prevent abrasions due to friction at the vulvar entrance.

Q: Is there a need to dilate the genitalia in Penile Peritoneal vaginoplasty (PPV) technique?

A: Yes, because the contraction of the wound can also narrow the entrance to the vagina.

Q: Is there a chance of contracting sexually transmitted diseases in the new genitalia?

A: There is a chance of contracting STDs by sexual intercourse at the new genitalia.

Q: Should a patient take hormone replacement therapy after sex reassignment surgery?

A: After sex reassignment surgery, female hormonal drugs must be used under the supervision of a physician to prevent “surgical menopause” or a sudden lack of sex hormones. Transgender women taking estrogen and anti-testosterone medication before surgery must stop taking the anti-testosterone medicines after surgery, and estrogen can be used singly.

Q: How often should patients visit the surgeon for a follow-up?

A: The patient should visit the hospital for follow–up during the first year after surgery to check the wound healing process and depth of the genitalia. After one year, the patient should see the surgeon at least once a year for an external genital examination and internal endoscopy.

Deciding to have SRS

There is no single correct way to decide whether or not to have surgery. It is natural to have doubts, fears, and anxieties about SRS, as with any significant life decision. However, as part of the decision-making process, you must be sure to proceed with surgery.

From our own experiences and from listening to many other people, we know that each person’s situation is unique, that there is no one way to decide, and that it is not as simple as a one-time yes or no. Instead, it is often a lengthy process shaped not only by internal feelings and beliefs but also by ever-changing external circumstances that are not always under your control (health, money, family responsibilities, limited access to services, etc.)

People, in our experience, make decisions about SRS in the same way they make decisions about the rest of their lives. For example, some trans-people seek a solid internal feeling that SRS is correct and do not want to be influenced by others. In contrast, others seek advice from friends, family members, other trans-people, counselors, or other health professionals as part of the decision-making process.

Some questions to consider are listed below, regardless of how you think things through. Of course, there are no correct answers to these questions; they are prompted for you to consider various aspects of SRS better to understand your feelings, values, and expectations.

• Do you have a clear mental image of how you want to appear after SRS?
• What do you think you’ll feel if the results don’t match your mental image?
• Do you expect SRS to fix anything, and if so, what?
• What aspects of your life might change as a result of SRS?
• What would you like to see change, and what would you like to stay the same?
• Do you believe your expectations for SRS are realistic? How can you tell if they’re genuine or not?
• How well do you understand the SRS options? What else do you need to know to make an informed decision?
• Do you consider the parts of your body that SRS will alter to be a part of your sexuality? What if you lose that aspect of your sexuality?
• Will your decision have an impact on anyone else in your life? How do you think they’ll react to the fact that you have SRS? What effect will their reactions have on you?
• What do you consider a “wrong reason” for having SRS? What do you consider to be the “right reasons”?

What SRS cannot provide for You

SRS can provide significant relief to trans-people and live more comfortably. But there are some things that SRS will not do.

1. SRS will not solve all body image issues.

The goal of SRS is to make you feel more at ease in your own skin by bringing physical characteristics closer to your internal sense of self. This alleviation can boost your self-esteem and make you feel more confident and attractive.

However, you will discover that there are attractiveness standards after SRS that you may not meet.

The social pressures and gender stereotypes about appearance make it difficult to be comfortable in your own skin. Unfortunately, some MTFs respond by obsessively dieting, exercising, or undergoing endless surgical revisions to achieve an idealized stereotype of attractiveness.

It can be challenging to distinguish between gender dysphoria and body image issues. Professional and peer counseling can help you sort out your appearance expectations and work toward greater self-acceptance after SRS.

2. SRS will not solve all sexual issues.

Wanting to feel more comfortable about sex is essential for some trans-people to have SRS. This is because SRS can help alleviate dysphoria, which harms sexuality. However, dysphoria is not the cause of all sexual problems.

Sexuality is a complex issue that various factors can influence, including physical problems, stress, relationship dynamics, body image issues, past sexual abuse or other types of trauma, and cultural and personal beliefs about sexuality.

SRS will not automatically resolve all of these issues in your life. If you are experiencing sexual difficulties, consider seeking peer or professional counseling to investigate the causes and learn about sexual health treatment options. If you need help finding a trans-positive sexual health professional, the Transgender Health Program can help.

SRS frequently has a positive effect on sexuality. Most Trans people who participated in numerous studies reported increased sexual satisfaction after SRS. However, SRS can have a negative impact. Changes in sensation are widespread following surgery. You may discover that touch is less intense or more intense (to the point of being uncomfortable or painful).

Some MTFs report difficulty reaching orgasm following genital surgery or that orgasm is less intense. When deciding whether to have surgery, you must consider the possibility that SRS will harm your sexuality and how you will cope with that possibility.

Whether or not you choose SRS, some trans-people find that counseling can help them deal with the effects of internalized transphobia on their sexuality. Many trans-people internalize negative messages about being Trans due to growing up in a transphobic society. This can include feelings of shame about erotic cross-dressing or other trans-specific sexual desires and fantasies, as well as feelings of guilt about having a body that does not conform to societal norms.

Peer or professional support can be beneficial in achieving greater self-acceptance of your sexuality (with or without SRS).

3. SRS will not transform you into someone else.

SRS causes many people to experience positive emotional changes. However, once the excitement wears off and you’ve incorporated the changes into your daily life, you’ll likely discover that if you were shy, you’re still shy. If you didn’t like your laugh, you still don’t, and you’re still afraid of spiders.

Whatever you consider being, your strengths and weaknesses will remain. Hopefully, you will be happier, which is beneficial to everyone. SRS may assist you in becoming more accepting of yourself. However, if you expect that all of your problems will go away and that everything will be easy emotionally and socially from now on, you will most likely be disappointed.

This includes mental health issues as well. Trans-people who are depressed due to gender dysphoria may find that SRS significantly reduces their depression. However, if your depression is caused by biological factors, transphobia-related stress, or unresolved personal issues, you may still be depressed after SRS. Similarly, if you have a problem with drugs or alcohol, SRS will not necessarily solve your problem.

4. SRS will not provide you with an ideal community.

For some trans-people, SRS is a ritual that confirms that they are who they claim to be. Making physical changes is a way of exposing yourself to the rest of the world so that others can see who you are. This process of self-discovery can be very liberating, but it does not guarantee acceptance or understanding.

Some MTFs believe that by undergoing physical transformations, they will be validated as “real” women or feel more accepted by the trans-community. However, the notion that trans-people aren’t “real” unless they change their bodies is transphobic, and communities or groups that hold this belief are unlikely to be fully respectful of trans-people’s identities and bodies.

It’s common to fantasize about finding an ideal community of trans-people during the various stages of transition. There may be a strong desire to connect with others who have gone through similar experiences when undergoing SRS.

There are a lot of really cool trans-people to talk to about SRS. However, having SRS does not automatically make trans people welcoming, approachable, or sensitive to the needs of others, and you will likely find that no trans person will exactly mirror your personal experiences, identity, and beliefs.

Being realistic about the possibility of feeling lonely and alone after starting hormone therapy is an integral part of emotionally preparing for SRS.

Am I Prepared?

It’s not enough to know if SRS is suitable for you; you should also see if it’s the right time in your life for SRS. Your readiness determines this for the physical stress and mental adjustment that SRS entails and your willingness to deal with the reactions of others.

As discussed in the booklet Getting surgery (available from the Transgender Health Program ), the patient must be physically and psychologically prepared for any surgery. Physical readiness denotes that you are in generally good health and have completed any physical requirements imposed by your surgeon (e.g., electrolysis before vaginoplasty).

Physical readiness also includes making plans for the physical care you will require following surgery, such as having a safe place to recover after surgery, understanding what is involved in aftercare, and having friends, family, or health professionals who can assist you.

Mental readiness does not imply that you are free of mental health issues or life stresses; instead, it means that you have:

1. A strong sense of one’s gender identity

SRS is not for people just beginning to question, explore, and think about gender identity issues. Allow yourself some time to get a clear sense of how you identify and how the surgery will contribute to this sense of self if you consider SRS as part of your initial process of exploring gender issues before making a decision.

2. Mental stability is sufficient to make an informed decision about your medical care

Making significant decisions during chaos and crisis is not a good idea. When you’re in a crisis, it can be challenging to think clearly and make fully informed decisions. If you’re having trouble making general life decisions because you’re overwhelmed by anxiety, depression, or drug or alcohol issues,

You’re not in a good place to make a big decision like whether to have surgery and what kind of surgery to have if you’re dealing with family problems, work problems, or other issues. So instead, seek peer or professional help to address whatever is interfering with your ability to think clearly, and then return to the question of whether SRS is necessary when your mind is clearer.

3. Sufficient coping skills and supports to withstand the typical SRS stresses after SRS , trans-people often feel exhilarated and liberated, but it is also common to experience emotional ups and downs. It can be challenging to adjust to changes in your body’s appearance and feel, to deal with pain or other physical complications, and to deal with the reactions of others.

For some loved ones, SRS is the first time it truly sinks in that gender issues aren’t going away and that you are, in fact, Trans. This can be a complex emotional process for them, affecting the support they can provide. SRS is not for you if you do not believe you have the emotional fortitude to deal with these possibilities.

If you are confident that SRS is suitable for you but are unsure whether you are ready at this time in your life, you do not have to abandon SRS entirely. Instead, you can still work towards SRS by considering what might help you get to the point where you are ready – counseling, advocacy, peer support, and so on – and gradually but steadily making life changes to get closer to readiness.

What Happens If I Change My Mind About Having Surgery?

Surgery is a humbling experience. Dissatisfaction, disappointment, and doubt are relatively common after any surgery, and (for Trans and non-trans people) typically relate to post-operative pain, surgical complications, the discrepancy between hoped-for and actual results, a sense of “now what?”, and other people’s reactions. These are normal parts of the adjustment process and usually resolve within the first year after surgery.

According to studies, approximately 1% of MTFs who undergo SRS have profound and long-lasting regrets.

If you are having difficulty coping with the ups and downs of surgery, peer and professional counseling can be beneficial. However, it is critical that the counselor has extensive experience with Trans issues and understands surgical matters.

Many people who have persistent regret come to terms with their decision to have surgery – even if they wouldn’t do it again, they believe it was the right decision at the time. On the other hand, some people decide that surgery and transition were not for them and wish to return to their pre-transition state. This is a significant decision that should not be made without professional advice.

Male to Female Surgery – Additional FAQs

Q1: will i be asleep during the male to female sex reassignment surgery.

The anesthesiologist will administer general anesthesia to keep you asleep and pain-free during surgery.

Q2: How long will I be in the hospital?

Answer : After surgery, you will be admitted for at least 7 – 9 days.

Q3: What will the post-op period be like?

Answer : To protect the surgical site, you will need to sleep with your legs separated for 5-7 days. During this period, you will be on a liquid diet with low fiber content so frequency of defecation is decreased. After about a week, you will be encouraged to start walking. Depending on your rate of healing, your doctor may also resume your hormone prescription after one week.

PRICE AND PACKAGES

Take the first step and contact us through our no-cost  virtual consultation . During this process, we will recommend options that will work best for you. Every client is different, so our virtual consultants and surgeons tailor the procedure to match each person’s needs.

Available Doctors

Dr. Kittichai Sipiyarak

Specialty: Plastic Surgery

Dr. Worapon Ratanalert

Contact us today.

Email Address

The Ultimate Guide to Gender Reassignment in Thailand

Last fact-checked: 4 January 2023

Gender reassignment surgery (also known as sex-change, gender affirmation, or sex reassignment surgery (SRS)) refers to medical procedures sought by transgender or non-binary individuals which align one’s physical appearance or functional ability with the gender to which they identify.

While such surgeries have become increasingly more commonplace around the world thanks to improved techniques and greater awareness of this often-stigmatized issue, the cost of gender reassignment surgery still poses a major stumbling block.

When traveling to Thailand, however, patients save between 60% to 70% on the cost of their surgery (which can total more than $40,000 in countries like Australia, the UK and the US), as well as skip the long waiting lists often found in the West.

Use Medical Departures to find a world-class surgeon in Thailand, one of the world’s leading destinations for gender reassignment.

What Is the Cost of Sex Reassignment Surgery in Thailand?

For many patients, the cost of undergoing gender reassignment surgery in their own country can be prohibitive. By choosing to undergo treatment in Thailand, treatment becomes a much more realistic and attainable dream.

The overall cost will depend upon the extent of the work to be carried out; as a general guide:

A male-to-female sex change (genital reconstruction only) operation in the US could cost as much as USD $25,000 - 30,000 (AUD 36,000 - 44,000)

In Thailand, the same medical treatment at an established, well-regarded facility costs around USD $7,000 - $12,000.

For patients seeking to add breast augmentation (implants), voice feminisation surgery, and Adam’s apple reduction (tracheal shave), prices may often exceed $50,000 in the West.

In Thailand, these surgeries generally cost around two-thirds less than in the US, UK or Australia. Thus, for a package that includes genital reconstruction, breast augmentation and voice feminisation surgery, the total cost is estimated to be USD $15,000 - $25,000.

See the table below comparing SRS prices in Thailand with other countries:

Is Gender Reassignment Surgery Covered by Insurance Companies for Healthcare Providers at Home?

Finding coverage for any transition-related surgery can be a long and challenging process for those who would normally rely on private health insurance.

Many states in the US, for example, have laws that explicitly exclude such coverage, while those companies that do offer financial help typically require patients to endure prolonged hormone therapy, show proof of “ persistent and well-documented gender dysphoria ” over a set period of time and present numerous referral letters from doctors, mental health professionals and even family.

Why Choose Thailand for Gender Reassignment Surgery?

At its peak, Thailand welcomes more than 40 million international visitors a year. And while most tourists are drawn thanks to the allure of the country’s beautiful beaches, ancient temples, sprawling jungles, luxury shopping and exotic cuisine, many others travel for the sole reason of taking advantage of affordable plastic surgery prices–which includes SRS–with treatment carried out in state-of-the-art clinics and hospitals by highly skilled, specialist doctors who are often recognised for their expertise at a global level.

Below, we sum up the reasons to choose Thailand for SRS and related sex affirmation treatments.

Quality of Care: The continued growth of medical tourism in Thailand has seen the emergence of a wealth of world-class facilities, staffed by internationally-trained medical experts.

From modern beauty centers focusing on only select treatments to specialized departments within larger private hospitals, medical travelers now enjoy a healthy choice of well-established facilities that have all been fully verified by Medical Departures. In fact, Thailand is home to the most Joint Commission International (JCI) hospitals in the region and is the gold standard of international medical accreditation.

Some of the Gender Reassignment Specialists:   It is also worth noting here that Thailand has been a pioneering country for gender reassignment ; the first surgery was carried out here in 1975. Today, around 90% of the patients undergoing surgery in Thailand are welcomed from abroad.

Scroll down to examine some of our top-rated SRS clinics and hospitals and Thailand, with each dedicated listing page providing more information about the facility, as well as photos, prices, doctor profiles and patient reviews.

Prices: As we have looked at above, patients can typically look forward to saving at least 50% on the price of an SRS procedure in Thailand; many indeed find that the total cost is closer to 70% less than private care in the US, UK and Australia–as these countries will often not include other essential expenses in initial price quotes, such as anesthesia, in-patient care, medication and even consultation fees.

To find out how much you can save in Thailand on sex reassignment surgery, as well as how you can benefit from our Best Price Guarantee , you can connect with our Customer Care Team any time of the day or night.

How to Find the Best Gender Reassignment Surgeons in Thailand

The Medical Departures team takes the necessary time to research the finest hospitals and doctors available, performing background checks to confirm doctor qualifications and verifying associations with professional medical organizations, such as the International Society of Aesthetic Plastic Surgery (ISAPS) .

How Do We Verify Clinics?

Our website contains exclusive listings of reputable clinics and surgeons available throughout Thailand. We have performed site visits to ensure that equipment and facilities are of the highest standard, and we conduct regular reviews with patients that have attended our clinics to ensure that they have received first-class service.

Considering this is a highly-specialized procedure, we make sure that every surgeon performing the procedure is a member of professional organizations both in Thailand and abroad. These can be found listed in the ‘Doctors’ section on each of our clinic/hospital listings, and include:

The Thai Medical Council

Society of Plastic and Reconstructive Surgeons of Thailand

Society of Aesthetic Plastic Surgeons of Thailand

International Society of Plastic and Reconstructive Surgery

Royal College of Surgeons of Thailand

Medical Association of Thailand

We also ensure that surgeons have undertaken rigorous training in the field, such as completing courses provided by the Global Education Institute (GEI) that follow globally-recognised guidelines, standards of care and best practices as set out by the WPATH World Professional Association for Transgender Health .

Best Sex Change Surgeons in Thailand

One of the top facilities in the country for various gender-affirming procedures is the highly-rated Kamol Hospital . Located in Bangkok, Dr. Kamol is globally recognized as one of the most experienced surgeons in the world for gender reassignment. A large team of surgeons is led by Dr. Kamol Pansritum, a world-renowned specialist in plastic surgery who has performed more than 10,000 cases of sex reassignment and facial feminization surgeries.

Kamol Hospital's specialists consist of gynecologists, oral and maxillofacial surgeons, dermatologists, anesthesiologists and other clinical professionals who work as a team to provide the utmost care in the Thai capital.

For more options, take a look at three more trusted facilities in Thailand that offer sex-change surgery to international patients:

Asia Cosmetic Hospital  (Bangkok)

Yanhee Hospital Health & Beauty   (Bangkok)

MAXi Cosmetic Surgery  (Bangkok)

> All Clinics and Hospitals for Gender Reassignment in Thailand

> Clinics and Hospitals for Gender Reassignment in Bangkok

About Gender Reassignment Surgery

Gender reassignment surgery (or “sex reassignment surgery” (SRS)) is the term given to the medical procedure (or procedures) that are utilized to alter the function and physical appearance of a patient’s existing sexual characteristics.

Sometimes referred to as Sex Reassignment Surgery (SRS), the treatment is designed to provide the patient with the physical appearance of their identified gender. The process is also known as sex realignment surgery, gender confirmation surgery or genital reconstruction surgery.

In Brief: What Surgical Procedures Can Gender Reassignment Entail?

There are numerous procedures that can fall under the gender reassignment umbrella, and these surgeries differ between trans men (female to male) and trans women (male to female). The main genital reconstruction procedures (m2f / f2m), are:

For trans men, genital reconstruction usually involves the construction of a penis through either a metoidioplasty or a phalloplasty.

For trans women, the surgical construction of a vagina usually entails a penile inversion or a process known as the sigmoid colon neovagina technique.

For both trans men and trans women, any genital reconstruction surgery will usually involve other procedures, such as:

Vaginectomy

Orchiectomy

Other Gender-Affirming Procedures & Plastic Surgery

“Top” surgery, to masculinise the chest

Facial feminization procedures, such as chin augmentation and rhinoplasty

Reduction thyroid chondroplasty (tracheal cartilage shave)

Voice feminisation surgery

Tracheal shave (Adam’s apple reduction)

Augmentation mammoplasty

Breast Implants

Hysterectomy/oophorectomy

What Does Male-to-Female Gender Reassignment Surgery Entail?

Ultimately, male-to-female surgery entails reshaping the male genitals into a form that has the appearance of and, where possible, the function of female genitalia. Before any surgery can take place, patients are usually required to undergo hormone replacement therapy (HRT) and, possibly, facial hair removal. Other procedures that a patient may decide to undertake include breast augmentation and facial feminization surgery.

Genital surgery, or vaginoplasty, involves the removal of the testicles before the skin and foreskin of the penis are inverted, keeping the blood and nerve supplies intact to retain sensitivity. A section of the glans penis can also be used to create a clitoris that is fully supplied with nerve endings.

Once this procedure is complete, further surgery (known as labiaplasty) is usually undertaken. This is usually carried out once the surrounding tissues, nerves and blood supply have recovered from the vaginoplasty and is designed to enhance the aesthetic appearance of the newly-created outer vulva.

Apart from genital surgery, patients may opt for other procedures to enhance the overall results. These can include:

Breast augmentation–otherwise known as breast enlargement, can be utilized if hormone therapy fails to yield the desired results (normally with the use of implants)

Facial feminization surgery–a range of cosmetic surgeries designed to modify bone or cartilage structures in areas such as the cheeks, nose, forehead, brow and jaw to give a more feminine appearance

Voice feminization surgery–called glottoplasty, this procedure is used to alter the range or pitch of the patient's vocal cords

Tracheal shave–the reduction of cartilage in the throat to reduce the size of the Adam's apple, giving a more feminine appearance

What Does Female-to-Male Gender Reassignment Surgery Entail?

Unlike the male-to-female procedure, many trans men considering female-to-male surgery do not always undergo genital reassignment surgery.

Specialists usually place more focus on altering the existing physical female anatomical traits to conform to a more masculine appearance. However, it is usual for a patient to undergo hormone treatment using testosterone before any gender reassignment surgery takes place.

Procedures usually include having the internal female sex organs removed (hysterectomy), undergoing a bilateral mastectomy (breast removal) and attaining a more typically male shape to the chest through chest contouring techniques:

Mastectomy–sometimes referred to as "top surgery," this involves the removal of the breasts, repositioning of the nipples, and subsequent reshaping of the chest to give a more masculine, contoured appearance.

Hysterectomy and bilateral salpingo-oophorectomy: a hysterectomy is the removal of the uterus, whilst a bilateral salpingo-oophorectomy (BSO) is the removal of both ovaries and fallopian tubes. For some trans men, this is undertaken to alleviate the discomfort of having female internal reproductive organs, but for many, it is done to reduce the risk of cancer.

Metoidioplasty and phalloplasty–these are genital reconstructive procedures (GRT) used to construct a new penis, either by enlarging the clitoris with androgenic hormones (metoidioplasty) or through using tissue grafts from other parts of the body in conjunction with an erectile prosthetic.

Risks and Complications

As with any other surgical procedure, sex change surgery comes with a set of potential complications, although risk factors can be mitigated by choosing a trusted surgeon (who will be working with an experienced anesthesiologist) as well as following the correct pre-surgical protocols.

Postoperative care is just as important as preoperative care: events such as genitalia swelling, bleeding, nerve damage, pain, inability to walk and difficulties with urination are some of the most reported complications in regard to sex change surgery.

Your surgeon will thoroughly explain any risks associated with surgery and anesthesia during an initial consultation.

For more information, read these  safety considerations regarding transfeminine bottom surgery  provided by the American Society of Plastic Surgeons.

Where to Go in Thailand for SRS

The first and most-traveled destination in Thailand for sex reassignment surgery is the capital, Bangkok.

Home to the best SRS specialists in the country, sex-change surgery—or at least the concept of it—is fairly commonplace here in this sprawling megacity and does not carry the same negative stigma that it can in many parts of the US, Australia and Europe.

Bangkok is one of the world’s leading medical tourist destinations and also one of the world's most popular spots in Asia for families, couples and solo backpackers looking for an exotic getaway. Before or after your surgery, you will discover a long list of attractions and activities to enjoy. From food, shopping and thriving nightlife districts to taking in the sights and culture of this temple-packed city – you’ll find this fascinating city provides endless opportunities for enjoying Thai hospitality.

Bangkok’s attractions are varied –from dazzling temples and floating markets to designer shopping malls and effervescent nightlife–where you can eat some devilishly delicious street food on the cheap, or indulge in a high-end dining experience at one of the city’s glitzy rooftop restaurants. Bangkok has everything a modern city should have while retaining the allure and uniqueness of the old city.

> Read More:   Ultimate Guide to Doctors in Bangkok

Another destination to consider for gender affirmation surgery in Thailand is Phuket. As the country’s largest island province, Phuket offers the same modern infrastructure and amenities as Bangkok–plus the welcome addition of tropical, white-sand beaches that are synonymous with this southern region next to the Andaman Sea.

Although not offering the same wide choice as the capital, we can recommend the superb Phuket Plastic Surgery Institute , which works with a team of more than 10 plastic surgery specialists. These English-speaking doctors are highly experienced and have earned international recognition as leaders in their particular disciplines, which include sex reassignment procedures.

> Read More: Ultimate Guide to Doctors in Phuket

Other Destinations in Thailand

If you are planning to enjoy some downtime before surgery, Thailand has a wealth of other top locations to choose from. Check out these destination guides aimed at medical tourists visiting Northern Thailand (Chiang Mai) and Chonburi province (Pattaya city).

> Ultimate Guide to Doctors in Chiang Mai

> Ultimate Guide to Doctors in Pattaya

In certain cases, medical tourists in Thailand do travel to another location following surgery to complete their recovery. This is usually only permitted following a set number of days or even weeks of bed rest after being discharged from the hospital. Always consult your surgeon about any travel plans you may have and follow aftercare instructions carefully (such as not swimming, engaging in vigorous activity and avoiding the hot sun).

Sex Change FAQs

Q. How old do I need to be for sex change surgery in Thailand?

A. Anyone 20 years old and older is eligible for gender reassignment surgery in Thailand. A person aged between 18 and 20 must receive consent from an authorized guardian.

Q. Will I have to undergo hormone therapy before getting a sex change in Thailand?

A. Yes, hospitals will typically require patients to have undergone hormone therapy for at least one year; reach out to one of our representatives for more information before you book.

Q. Can different sex reassignment procedures be performed concurrently? A. Yes, a team of surgeons can perform certain procedures during the same session of surgery, such as penile inversion vaginoplasty combined with voice feminisation. Other reconstructive surgeries, such as breast/chin augmentation may need to be done separately.

Q. How long do I have to wait to see an SRS surgeon in Thailand?

A. Waiting times for any type of surgery in Thailand are generally much shorter than in the West; Medical Departures can facilitate an initial consultation in a matter of days, depending on the hospital/surgeon of choice.

Q. How long will I need to stay in Thailand to complete my sex change?

A. This will depend on the number and type of procedures to be performed; on average, inpatient length of stay is estimated to be between 5 - 14 days. Your doctor will advise how long you’ll need to stay in the country for recovery and post-surgery care.

Q. How much Is sex change surgery in Thailand?

A. SRS surgery in Thailand typically costs between $7,000 - $12,000 (penile inversion); other associated surgeries generally cost around one-third of prices in the West. You will want to confirm pricing and treatment plan with your chosen clinic(s).

How Do I Get Started?

 Booking through Medical Departures maximizes your savings thanks to our Best Price Guarantee  which ensures that you pay the lowest rate possible for your treatment. We can even help with additional medical insurance by putting you in touch with a number of independent insurance providers who can offer you preferential rates on their policies.

In Thailand, gender reassignment is affordable and delivers outstanding results. To find out how much you can save, get in touch with a member of our Customer Care Team now and start planning your life-changing surgery today.

How Thailand Became a Global Gender-Change Destination. Bloomberg. 17 October 2015. https://www.bloomberg.com/news/features/2015-10-26/how-thailand-became-a-global-gender-change-destination

WPATH World Professional Association for Transgender Health. Website accessed: 28 November 2022. https://www.wpath.org/gei

International Society of Aesthetic Plastic Surgery. Website accessed: 28 November 2022. https://www.isaps.org/

Joint Commission International. Website accessed: 28 November 2022. https://www.jointcommissioninternational.org/

Brazier, Yvette. What you need to know about breast augmentation. Medical News Today. 3 April 2017. https://www.medicalnewstoday.com/articles/263567.php

Vaginoplasty and Labiaplasty. WebMD. 19 April 2019. https://www.webmd.com/women/guide/vaginoplasty-and-labiaplasty-procedures

A, Brooke. Is Gender Reassignment Surgery Covered by Health Insurance? Mira. 23 August 2022 .https://www.talktomira.com/post/is-gender-reassignment-surgery-covered-by-health-insurance

Transfeminine Bottom Surgery. American Society of Plastic Surgeons. Website accessed: 28 November 2022. https://www.plasticsurgery.org/reconstructive-procedures/transfeminine-bottom-surgery/safety

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• Health Articles

Gender Affirmation Surgery - Male to Female

• Patients looking to undergo gender affirmation surgery must first complete The World Professional Association for Transgender Health (WPATH) Recommendations, Version 7 Assessment (Coleman, et al., 2011). 

The side effects that cause the most anxiety among patients undergoing gender affirmation surgery are the esthetic and sensation results from the newly formed organ. These results are dependent on several factors. Fortunately, experienced surgeons can provide advice and recommendations regarding suitable techniques that will ensure surgery outcomes closely match a patient’s desires while minimizing side effects. 

There are now a range of gender identities and sexual orientations, as well as a range of popular gender affirmation surgical techniques available for those wishing to make a physical change. Additionally, new surgical techniques are being developed by surgeons around the world all the time to ensure the best results can be achieved with minimal side effects. 

Gender affirmation surgery (male to female)

Gender affirmation surgery (male to female) is undertaken with the aim of altering the male genitalia to externally appear like female genitalia, with function and sensation similar to that of a vagina. This is achieved by surgical alteration of the testicles to create a vaginal cavity through which intercourse can take place. 

There are a number of surgical techniques available to achieve this, including orchidectomy, vaginoplasty, and labiaplasty. In addition, new techniques are continuously being developed, such as sensate clitoroplasty, labia minora reconstruction using the testicular sac, intestinal vaginoplasty, and endoscopic peritoneal flap vaginoplasty. All of these procedures can provide results that closely match the desires of the patient wishing to affirm their gender through surgery. 

In addition to genital reconstruction techniques, there are a range of other surgeries used to affirm a person’s gender, such as facial feminization surgery , tracheal shave surgery, voice feminization surgery, breast augmentation, buttock augmentation, and hair transplants.

Patients suited to gender affirmation surgery

• Transgender women (TGW) who have completed The World Professional Association for Transgender Health (WPATH) Recommendations Version 7 Assessment (Coleman, et al., 2011) 
• Patients within normal weight ranges (those looking to lose weight should do so before undergoing surgery) 
• Patients with no underlying health conditions that would prohibit surgery, such as hemophilia and Ehlers-Danlos syndrome 
• Patients looking for realistic results 
• Patients of sound mental health 
• Patients over 20 years of age (those under 20 must first seek permission from a parent or legal guardian) 

Potential risks and side effects associated with gender affirmation surgery

All forms of surgery carry with them an inherent risk that can affect anyone going under the knife. Nevertheless, the consulting doctor will carry out a risk assessment, and offer patients the chance to seek answers for any concerns they may have before deciding whether or not to undergo surgery. 

Patients with no history of keloid type scarring are usually able to achieve a smooth looking finish to the skin, with incision scars hidden in suitable places. 

Other potential risks include wound complications, numbness, and skin necrosis, however these are most common among smokers or patients with underlying health conditions associated with the vascular system, such as diabetes, high blood pressure, and hyperlipidemia. Nevertheless, if these conditions are managed effectively, they should not prohibit surgery. 

Why should you choose gender affirmation surgery at Samitivej Srinakarin Hospital in Bangkok, Thailand?

Samitivej Srinakarin Hospital uses the latest techniques that help surgeons before, during, and after surgery. Our surgeons have been performing gender affirmation procedures for more than 20 years, and patients can feel confident knowing that their desired outcomes are achievable due to the modern techniques utilized by our expert medical team. 

Preparing for gender affirmation surgery

6 months prior to surgery 

• Stop taking all forms of acne medication containing vitamin A (isotretinoin) because it can have a detrimental effect on the healing of scars 

3 months prior to surgery 

• Prepare the body for surgery with a light exercise regime and plenty of rest 
•  Undergo an annual health screening and, should you have any underlying health conditions, be sure to consult your doctor in order to ensure they are under control 

4 weeks prior to face lift surgery 

• Avoid smoking for at least 4 weeks preceding surgery, and again for at least 4 weeks following surgery 
• Avoid getting any new piercings/tattoos and avoid all forms of sunbathing; should you already have a piercing, make sure it is removed and cleaned regularly to avoid inflammation 

10 days prior to surgery 

•  Anticoagulants, including aspirin, coumadin, Ticlid, Plavix and Aggrenox (consult your physician regarding the safe halting of any medication) 
• NSAID drugs, including Ibuprofen, Advil, Motrin, Nuprin, Aleve, Relafen, Naprosyn, Diclofenac, Naproxen, Voltaren, Daypro, Feldene, Clinoril, Lodine, Indocin, and Orudis 
• Sedatives, including Zoloft, Lexapro, Prozac, and Pristiq 
• Consult your physician regarding the safe halting of any medication 
• Avoid all vitamin supplements that can interfere with blood clotting, such as fish oil, omega-3, co-enzyme Q10, evening primrose oil, glucosamine, arnica, ginseng, gingko, and herbs. 

In addition to following the prior list of recommendations, patients should attend a medical consultation regarding gender reassignment surgery to better understand its potential risks and benefits, as well as to address any misconceptions and ensure all parties share a full understanding of the desired results. 

For more information, please visit the following websites: 

• https://www.isaps.org/member-directory
• https://www.thprs.org/find-doctor
• https://checkmd.tmc.or.th

Steps involved with gender affirmation surgery

• Medical staff will provide the patient with adequate time to consult and ask any questions before surgery 
• The surgery usually takes 4-5 hours to complete 
• A trained anesthesiologist will administer a general anesthetic 
• Patients will be required to stay in the hospital for 5 days following the surgery 
• Follow-up consultations to monitor the patient will be held on days 7 and 14 following the procedure 

Post-surgery care following gender affirmation surgery

Recovery times differ depending on a range of factors, such as the patient’s general health prior to surgery, the type of surgery performed, and post-surgery care. 

• There may be some moderate pain or aching at the incision site 
• Patients should be able to get up and walk around 2 days after surgery 
• Patients can take a bath 5 days after surgery, although they should pay special attention to their wound and and perform vaginal dilation in accordance as advised by their doctor 
• There may be swelling lasting 3-6 months following surgery 
• There may be reduced sensation in the area operated on, but this should return completely within 3-6 months. 
• There may be redness and swelling in the affected area for the first 1-3 months following surgery, but this should improve within 6-12 months 
• Patients should avoid exposure to direct sunlight for the first 3-6 months 
• Patients should be able to return to work within 4-8 weeks 
• Patients should avoid all forms of exercise for 4-6 weeks after surgery 

Despite various forms of gender affirmation surgery becoming ever more popular, they are extremely complex procedures that must only be performed after thorough consultations with doctors who have specific expertise in this field. It should then be left to similarly-experienced surgeons to perform the procedure, as they will be able to ensure the highest level of safety, minimal side effects and the most desirable outcome. 

Samitivej Plastic and Esthetic Surgery Institute is a full-service plastic surgery center in the heart of Bangkok, Thailand. Our qualified specialists from Board Certificated Plastic and Reconstructive surgeons performs a large selection of operations to help your outside look the way you feel on the inside with an excellence care on all surgical procedures. We specialize in breast surgeries such as breast augmentation, breast lift and breast reduction. Our plastic surgeons are also experienced in Face lift, body contouring procedures; body lifts surgeries after significant weight loss. We also do combination surgeries of breast, tummy and many other areas. 

Besides Plastic and Reconstructive surgeons, our interdisciplinary team including nurses, anaesthesiologists, cardiologist, and other subspecialist will make sure of your safety. 

Samitivej has a team ready to help and provide services for:  

• Treatment Plan Consultation with a doctor via online video-call (second opinion) 
• Treatment Planning if you have medical records or a price estimate from another hospital 
• Cost Planning by our Appraisals Team with price guarantee (only for procedure packages without complications) 
• Check Initial Coverage Eligibility with Thai and international insurance companies (only for insurance companies in contract with the Hospital) 

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• Home     >     Treatments     >     Gender Reassignment Surgery Cost in Thailand

Gender Reassignment Surgery Cost in Thailand

Cosmetic and plastic surgery.

Bangkok, Thailand, has been the unquestionable leader in the field of high-quality gender reassignment procedures for decades. Thai Medical provides you with the opportunity to realize your dreams by employing one of the world’s best SRS surgeons and cutting-edge surgical techniques. Thai SRS surgeons are considered one of the best in their expertise. Thailand offers a wide range of cosmetic and plastic surgery procedures to patients from all over the world, and Thai experts have performed many natural-looking sex Reassignment procedures in Thailand. People from Australia, the United Kingdom, France, the Middle East, America, and Brazil are looking for the best results at the lowest possible cost. Gender reassignment surgery in Thailand is significantly less expensive than in the United States, Europe, or other developed countries. Part of the success can be attributed to Thai hospitals’ use of cutting-edge medical equipment and knowledge. Aside from these advantages, one of the main reasons is its ability to provide affordable cosmetic and plastic surgery in Thailand while maintaining clinical standards.

What is Gender Reassignment Surgery?

Gender Reassignment Surgery is a surgical operation, or a set of surgeries, designed to change a transsexual person’s physical attributes and sexual preferences so that they more closely reflect those of their assigned gender. GRS Gender Reassignment Surgery in Mexico is also referred to by a number of other names, including Sex reassignment surgery (SRS) , Gender Confirmation Surgery (GCS) , and others.

Standards of Care, including psychological testing and a period of practical experience living in the preferred gender, have been developed by professional medical organizations and must be met before a person can choose to have reassignment surgery. Multiple methods are used in Gender Reassignment Surgery (GRS), which can be done on either males or females who are transitioning into the other gender.

Why is Thailand a Top Destination for Gender Reassignment Surgery?

Given that it has one of the most welcoming societies, Thailand is noted for being able to support a significant transgender community. International patients are increasingly coming to Thailand each year to have sex change surgery. Thailand is the Gender Reassignment Capital of the World due to its accessible healthcare, skilled and experienced surgeons, and accepting society toward gender identity.

Patients from all over the world choose Thailand’s top hospitals due to a number of extra benefits, including access to state-of-the-art facilities, the flexibility to combine vacation and leisure time with treatment, and the simplicity of acquiring a visa.

Thailand is recognized for providing a wide range of operations performed by medical specialists who were educated in Western countries. Additionally, a lot of doctors speak English well in order to deliver top-notch care.

Know More – Medical Tourism in Thailand

An Overview of Thailand’s Medical Benefits

• The price is quite affordable. In Thailand, healthcare is affordable, especially if your health insurance pays all or some of the costs.
• Beautiful lodging options can be found in Thailand near a number of tourist sites. It is the perfect place to unwind and recover from the following therapy.
• The tropical climate frequently quickens the healing process.
• English is a common language among Thailand medical personnel. As a result, you shouldn’t worry about a possible communication breakdown.
• Thailand is a travel destination that is fairly priced. You travel on plush airlines, and tickets are frequently very affordable.
• Thailand rarely has lineups, unlike many Western countries. Surgery scheduling is comparable to vacation planning. When it’s convenient for you, you receive care.
• The installation of crowns, teeth whitening, LASIK eye surgery, and the eradication of warts and moles are just a few of the more routine operations that can be done in Thailand in addition to more sophisticated ones.

What are the Two Types of Gender Reassignment Surgery?

Below are the two types of GRS :

1. Feminization Surgeries (Male to Female):

• Vaginoplasty: In a vaginoplasty, existing genital or abdominal tissue is used to create a new neovagina or neovulva. 
• Penile inversion: Penile inversion is a popular vaginoplasty method. The penis glands are turned into a clitoris, and the testicles and scrotum are removed.
• Bowel vaginoplasty: A typical vaginoplasty procedure is bowel vaginoplasty. Similar to penile inversion, vaginoplasty involves the removal of the testicles and scrotum, the clitoris-making of the glands, and the construction of the neovulva from the scrotum and urethra.
• Vulvoplasty : The clitoris, inner and outer labia, and the vaginal entrance are created externally during vulvoplasties by the surgeon using tissue from the penis. Patients must stay in the hospital for three days following a vulvoplasty.
• Orchiectomy: Testicles are surgically removed from the body during an orchiectomy. In comparison to vaginoplasty or vulvoplasty, it is much easier to execute and can be finished in under 20 minutes with a local anesthetic.
• Chest reconstruction: For transgender men to physically transition to their self-affirmed gender, this treatment is used.  In this, the scarring is reduced, the nipple and areola are adjusted, and the chest wall is reshaped and reduced.

2. Masculinization Surgeries (Female to Male)

A person will receive testosterone replacement medication prior to having the gender-affirming surgery to change them from female to male.

• Hysterectomy and bilateral salpingo-oophorectomy: The surgical removal of the uterus is known as a hysterectomy.
• Phalloplasty: By using a flap (transplant) from the patient’s arm, thigh, belly, or back, phalloplasty creates a neopenis.
• Metoidioplasty: The process of creating a new penis or neopenis is called a metoidioplasty. After the clitoris has grown larger due to hormone replacement therapy, metoidioplasty is carried out. To enable the urine to flow while standing, the neopenis is constructed through an expanded clitoris, either with or without urethral extension. During the procedure, the surgeon also removes the vagina.
• Penile Implants: When a neophallus needs to obtain a proper erection, phalloplasty surgery uses a penile implant. In order to cure erectile dysfunction in cisgender males and to perform gender reassignment surgery on transgender men, penile implants are used.
• Facial Masculinization: Racial masculinization modifies physical characteristics to produce a look that more closely matches desired gender identification.

You can accomplish this by: Options for surgery include chin, brow, upper lip, and nose restoration. Non-surgical alternatives include injections to change the chin and jawline.

What is the Cost of a Gender Reassignment Surgery in Thailand?

A Sex Reassignment Surgery (SRS) in Thailand costs around one-third less than one in the United States. Thailand ranks first in terms of affordable healthcare, gender-transition surgery specialists, and medical facilities. The cost of a Gender Reassignment Surgery in Thailand starts from USD 11000.

The entire cost of a Gender Reassignment Surgery in Thailand can vary depending on a number of criteria, such as:

• The price of treatment packages can depend on the hospital’s preference.
• Doctor’s competence and experience in the subject.
• The patient’s situation: The patient’s disease and whether additional modalities are required for comprehensive treatment.
• Duration of hospitalization and stay in the country.
• Need for post-operative care.
• Hospital room classification.

These are the main factors driving thousands of patients to Thailand from around the world for medical care.

How to Choose Hospital in Thailand for Gender Reassignment Surgery?

Hospitals in Thailand that treat patients are renowned for their warmth and attentiveness to their needs. These hospitals are home to some of Thailand’s top Cosmetic surgeons who are experts in their areas. For an international patient, selecting a good hospital for treatment might be challenging. It is a crucial choice that needs to be made while keeping a number of things in mind, such as:

• Quality certificates and accreditations
• Hospital and transportation facility location
• Team of doctors and surgeons
• Advanced diagnostic and therapeutic equipment
• International patient assistance

How can Medsurge India Help? 

Medsurge India is a prestigious support system for patients looking for doctors, hospitals, and specialized treatments. We’ll find the most suitable medical options for you. Regarding your medical issues, our team will give you a list of certified, reputable, and trusted doctors and hospitals. Additionally, we offer a treatment strategy that fits your budget. Apart, we assist patients with obtaining travel authorizations, medical visas, and a multitude of other things.

The Most Important Frequently Asked Questions

Q: How do they perform male-to-female gender reassignment surgery?

A: Gender Confirmation Surgery The penis is turned inside out to form the inner walls of the vagina during a process known as “penile inversion.” The penis head is then used to make a clitoris. The urethra is shortened and repositioned, and the outer and inner labia are formed.

Q: What happens after gender reassignment surgery?

A: People who undergo male-to-female gender reassignment surgery keep their prostates. Following surgery, estrogen (a female hormone) stimulates breast development, widens the hips, inhibits facial hair growth, and slightly raises voice pitch.

Q: At what age can you change your gender?

A: While there are no laws requiring a person to be of a certain age to receive sex-change hormones or surgery, insurers have generally refused to cover minors, despite the fact that some doctors see benefits in treating children before puberty.

Q: Can phalloplasty help you get erect?

A: The end result is a penis that appears natural and may be capable of erections. Phalloplasty, when performed as part of transgender surgery, assists you in achieving your desired gender identity. Other advantages are dependent on the options you select: Radial forearm-free flaps produce excellent cosmetic results as well as improved sensation.

Q: Can gender surgery reverse?

A: Because these surgeries cannot be reversed, they are usually performed at the end of a long-term process that includes an accurate diagnosis of gender dysphoria, counseling about treatment options, and assisting the person in preparing for hormone treatment and surgery, if desired.

Q: Is it possible to choose a child’s gender?

A: The only true way to choose your baby’s sex is to use IVF with preimplantation genetic testing (PGT). IVF is a fertility treatment in which eggs are fertilized in a laboratory by sperm. When an egg is fertilized, it develops into an embryo.

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Sex Change Operation (Sex Change Surgery) At Bangkok Plastic Surgery

Sex change operation or also known as sex change surgery is a procedure that changes genital organs from one gender to another. It plays a critical part in a person’s transition from one gender to another. To accomplish these goals, many small steps are necessary that require time, patience, and expertise. Sex change operation is both cosmetic and reconstructive, so maximum attention to detail is necessary to achieve the best result. A great deal of experience is needed to be able to provide patients with the desired aesthetic appearance and functionality. And Dr. Pichet of Bangkok Plastic Surgery Clinic is among Thailand’s top surgeon who has expertise in Sex change operation field.

A COMPLEHENSIVE PROCEDURE

Sex change operation is done under general anesthesia and takes 5-6 hours of surgery. This procedure is always performed under general anaesthetic. There are 3 main stages of Sex change operation;

1. Elective Bilateral Orchiectomy (MTF)

It’s the operation for the removal of both testicles. After each testicle is pulled from the scrotum, its spermatic cord is clamped, double sutured to control bleeding, and cut, releasing the testicle. The end of the cord is then placed back in the body. Transitioning MTFs undergo orchiectomy because it significantly reduces testosterone production. The reduction of testosterone may allow a person with a male body to transition to a woman and to take less estrogen.

2. Tracheal Shave

It involves surgically reducing the tracheal cartilage (the Adam’s apple). A small incision is made at the front of the throat and the cartilage is carved until it is flat. This results in a throat contour that is flatter and more feminine in appearance.

3. Vaginoplasty

It’s the surgical construction of a vagina through skin inversion, involves removing the organs and erectile tissue of the penis. The skin and tissue is used to create a vaginal opening, clitoris, clitoral hood, and labia (lips). The urethra is kept for urination and the skin and nerves of the glans (head) of the penis can be salvaged for sensitivity.

Each patient is unique and the procedures that are done are based on the individual need and budget. Before the operation, preparation through education, information about the surgery, the choice of the right specialist, being sure about it yourself, etc. are necessary for a successful operation and satisfaction for everyone.

THE AESTHETICAL SURGERY CENTER

At our Bangkok Plastic Surgery Clinic, you can find help in every area of transitioning from therapy to aesthetics. Using highly specialized reconstructive and aesthetic surgical techniques, Dr. Pichet and his qualified surgical team can perform a full Sex change process to achieve a successful outcome in terms of both appearance of the genitalia and its function.

All Services

• Rhinoplasty Surgery (Nose Surgery)
• Blepharoplasty Surgery
• Breast Uplift Surgery
• Double Eyelid Surgery
• Facial Plastic Surgery
• Breast Augmentation Surgery
• Facial Feminization Surgery (FFS)
• Hair Transplant Surgery
• Face Lift Surgery
• Sex Change Surgery (SRS)
• Liposuction Surgery
• Lip Augmentation Surgery
• Cheek Implants Surgery
• Abdominoplasty Surgery

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Gender Reassignment Surgery in Thailand

Bangkok Thailand is the undisputed leader of high quality Gender Reassignment surgeries for decades. Thai Medical offers you the ability to make your dreams come true with one of the best SRS surgeons in the world, using the latest and most advanced surgical techniques. The expertise of Thai SRS surgeons is second to none. Our doctors have performed thousands of natural looking sex Reassignment surgeries for clients across the globe. From Australia,UK,France,Middle East,America and Brazil, our clients are looking for the best results at the best prices.

SRS Interview with Loren – SRS Surgery in Thailand

Changing the gender you were born with is a serious life long commitment so we help our clients get the information they want about their surgeries before they even arrive. We are 100% independent and can offer you impartial and honest opinions about the best doctors and top hospitals in Thailand for SRS surgery.

Not everyone is a candidate for SRS Sex Change Surgeries. Clients must be over 18 years of age to apply for surgery. Candidates for SRS surgery should also already have been clinically diagnosed with gender identity or gender dysphoria disorders along with any anxiety or depression that comes with feeling trapped in the wrong body. Doctors also recommend that you have atleast one year of hormone replacement before having surgery.

Other recommendations before having surgery include actually living full-time in the desired cross-gender role. This crucial step is often the most important step a person should take before committing to having Gender Reassignment Surgery in Thailand.

Types of Treatments Available

Male to Female Sex Reassignment Surgery  – MTF 

Male to Female Sex MTF SRS Thailand

  Female to Male Sex Reassignment Surgery – FTM

If you are interested in changing your birth gender, or to get more information about Sex Reassignment Surgery in Thailand please contact us today .

“Shape your Dreams into Reality with Thai Medical”

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‘They just go to Thailand’: the long and costly wait for gender-affirming surgery in Australia

Transgender Australians seeking lower body procedures can go to just a handful of local surgeons. It means long waits, huge costs and difficult decisions

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T wo years ago, Kavitha Sivasamy, an articulate, elegant Canberra lawyer, began to face her fears about undergoing gender-affirming surgery. “It’s really scary to go through something so invasive,” she says.

Gender dysphoria had been causing “a lot of distress” in Sivasamy’s day-to-day life. “It can prevent you getting out the door, having and keeping a job, sustaining healthy relationships,” the 27-year-old says. “The list goes on.”

She embarked on a course of hormone replacement therapy, and she liked the physical changes she was seeing, but this meant her “genital dysphoria became more salient”. There was a disconnect between her aspirations for her body and how it looked in the moment.

But Australia is facing a shortfall in surgeons who perform lower body gender-affirming procedures. So , in a route that experts say more Australian trans people are taking, Sivasamy will travel to Thailand for surgery under a medical tourism company’s “one-month care package”. Like some others, she will access her superannuation to pay for the $30,000 procedure.

Sivasamy made her choice after spending many months researching the experiences that others had of surgery. She decided a peritoneal pull-through, adapted from a procedure pioneered in India on cisgender women born without a vagina, was the type of vaginoplasty with the most positive benefits for her.

The standard vaginoplasty has long been a penile inversion, where penis skin is refashioned as the lining of a new vagina. The newer method, using tissue from the patient’s peritoneum membrane in the abdominal cavity, is said to offer greater vaginal depth. However, there is a lack of data on post-surgical quality of life for trans patients.

Sivasamy had been referred to Dr Kieran Hart , a Canberra-based urologist who performs this procedure, but she soon learned that she might have to wait a year and a half to have the surgery here. The idea of delay only compounded her distress.

“Having overcome family, workplace and social barriers, why put the critical years of your 20s and 30s on hold because of the wait in Australia?” she says. She will fly to Bangkok in May.

One surgeon, 120 patients waiting

Only a handful of Australian surgeons offer lower body gender-affirming surgery such as vaginoplasty for trans women, with even fewer offering phalloplasty (penis creation) for trans men. No surgical college offers formal training guidelines, forcing doctors to learn overseas.

Trans health advocates say Medicare is “woeful” and failing to offer any item numbers for medical procedures specifically for gender incongruence, causing confusion about what, if any, aspects of gender-affirming surgeries are eligible for government subsidy.

Private health insurance coverage for gender-affirming surgery is often prohibitively expensive. Even a fully insured person is left out of pocket by up to $20,000 for a vaginoplasty performed in Australia.

An evidence brief prepared in 2021 by the New South Wales community health organisation ACON found that most states and territories have elective surgery policies that “explicitly restrict access to surgical interventions for trans people through public health systems”, forcing trans people into local private care or surgery abroad.

Dr Clara Tuck Meng Soo , a GP and the president of the Australian Professional Association for Trans Health (Auspath), says a lot of her patients “now don’t even bother to go on the waitlist; they just choose to go to Thailand”.

“We have very high rates of mental health harm , and this care and affirmation and support is critical to reducing that harm,” says Soo, who is a trans woman. “But shouldn’t we also be able to access care that we feel we need as a human right?”

Hart says he has 120 trans patients booked and waiting for gender-affirming surgeries, with another 70 scheduled for consultations, and estimates “probably 10 times more” trans people are waiting for surgery across Australia.

Hart has closed his bookings and will reopen them in the second half of this year for consultations to be held in 2024 – with potential surgeries months later.

However, he says he will expedite a surgery if a psychiatrist or family is worried a patient might not survive an 18-month wait. Transgender people have vastly higher self-harm rates than the general population – a 2021 study found 43% of trans Australians surveyed had attempted suicide .

Like others performing lower body gender-affirming surgeries in Australia, Hart came by training in the area by chance: he was taught by the late Phil Thomas at London’s Charing Cross hospital. Hart had only travelled there to train in prostate and bladder cancer surgery.

Based on follow-ups of how patients fared physically and mentally after the procedures, Hart is “convinced” that surgery “must drop the suicide rate”.

Over the past year, Hart’s workload increased in part because of the waves of referrals he was getting from two surgeons winding down their vaginoplasty procedures, including Melbourne plastic surgeon Andrew Ives . Until recently Ives a high profile in the field, but, as his office confirmed in an email, he ceased performing vaginoplasty and labiaplasty procedures at the end of 2022.

In February, Melbourne’s Monash Gender Clinic told patients that it was only then booking appointments for patients referred in August 2021, and that Melbourne plastic surgeon Cheng Lo , trained in vaginoplasty and labiaplasty by Ives, has “very long wait lists”. Cheng did not respond to interview requests.

Hart says: “Andy Ives and I were looking at doing a formalised training program [for gender-affirming surgery], and as he stepped back I’ve looked at doing it myself, but it’s a daunting task. The [Royal Australasian] College of Surgeons has been a bit slow on the uptake for it, like every facet of the transgender sphere.”

In May, the college will hold a scientific congress titled Equity in Surgery in Adelaide, including for the first time talks on transgender healthcare. The college’s president, Sally Langley, admits in the program that the college’s surgeons “have not fully represented the gender … composition of our community”, but declined an interview request.

The many kinds of risk

Sivasamy acknowledges there are “risks” in having surgery in Thailand, but says the country “pioneered a lot of these procedures”.

Travelling abroad for these surgeries, even to a country that has pioneered them, comes with warnings of caution. Soo mentions reports of trans women suffering vagina narrowing or urethra complications after surgery, both in Australia and overseas. The question is: once the patient is back in Australia, who corrects the error?

Hart says surgeons are reluctant to fix another surgeon’s mistakes: “It’s impractical coming from Perth to Canberra to have it fixed up, but it’s far more practical than getting to Bangkok. As a developed nation there’s no reason people should be going overseas.”

Soo says there is also a shortfall of GPs, psychologists and other practitioners in trans health, but evidence “shows if you provide gender-affirming care, be it hormone treatment, surgery and/or social affirmation, [trans] people have very good mental health virtually indistinguishable from cisgender peers”.

Associate Prof Nicola Dean, the president of the Australian Society of Plastic Surgeons, says the federal government must create a dedicated suite of Medicare rebate item numbers for procedures for people with gender incongruence. This would encourage more surgeons into the field, Dean says, giving the surgeries a “stamp of legitimacy”.

For instance, the Medicare item number for a mastectomy was created on the assumption the procedure would be for a cisgender woman with breast cancer. “So using it for a trans man having surgery [to affirm his identity] leaves the doctor feeling vulnerable about whether they’re allowed to use those item numbers,” Dean says.

“It leaves the patient vulnerable because they’re often not sure of the financial implications.”

Associate Prof Peter Haertsch , a Sydney-based plastic surgeon, says he continues to perform about six vaginoplasty procedures a year. At his peak he was performing 30 gender-affirming procedures a year in Australia, beginning in the late 1980s after training in London.

Heartsch says some Australian surgeons have recently exited the field, but he doesn’t know why. “I have tried and am still trying to get some form of help in the way of government funding,” he says.

Another Sydney plastic surgeon, Dr David Caminer, says he performed his first vaginoplasty on a trans person in 2015, after which he toured the US and Europe to watch surgical units perform gender-affirming surgeries.

Up to the end of 2022 he had performed only a few vaginoplasties on trans patients, mainly with the penile inversion technique. But Caminer says so far in 2023 he has performed seven vaginoplasties due to the growing demand. “It was really since Andy Ives stopped doing it that I’ve been inundated with requests,” he says.

The Brisbane-based Dr Hans Goossen , who did not respond to interview requests, performs nearly all the phalloplasty procedures on trans men in Australia, according to the various trans health advocates Guardian Australia spoke to. Another surgeon, the Melbourne-based Dr Gideon Blecher , “has trained in phalloplasty and he is still trying to establish the program in Melbourne”, a spokesperson for Blecher said.

Fiona Bisshop, a Brisbane-based GP and former president of Auspath, says phalloplasty is particularly difficult for trans men to access in Australia, costing more than twice as much as a vaginoplasty. Bishop says almost all phalloplasty procedures have some complication, but three of her trans male patients who went overseas had particularly “terrible outcomes”.

“You can have some very bad experiences over in Thailand,” she says. “There are communication difficulties: the surgeons and hospital staff don’t speak very much English.”

Bisshop says many of her trans patients have “given up on gender-affirmation surgeries, because it is completely out of financial reach”, and she calls the “lack of respectability” afforded to gender-affirming surgery a “vicious circle”, because it is not offered in Australian teaching hospitals where physicians would normally train.

Gender-affirming care

Sydney-based Teddy Cook , ACON’s director of community health, says gender-affirming care means many types of “health interventions of critical need”, and such needs must be “depathologised” and trans people given autonomy.

The lack of comprehensive gender-affirming healthcare in Australia may be because this care is misunderstood as simply cosmetic or solely related to genital surgery, and because trans people are “seen through a lens of being mentally ill, as opposed to just being a natural part of human diversity”, Cook says.

Cook, who is a trans man, says not all trans people seek surgical intervention: “It’s up to the individual what sort of steps they take medically, but cruel legal gender recognition laws in NSW and other states still force surgical sterilisation to update a birth certificate.”

Cook says no reliable figures exist on how many trans people there are in Australia to better plan health services. When unveiling a 10-year national action plan for LGBTQ+ health in March, the assistant health minister, Ged Kearney, said attorney general Mark Dreyfus “might have things to say” about counting LGBTQ+ people in the census, but no announcement has been forthcoming.

As Sivasamy readies for her flight to Thailand, she knows she is one of the lucky ones, not least because she has enough money at a young age to finance the trip.

“The majority of people my age don’t have the superannuation funds to get this done,” she says.

She then opens her palms and waves her hands away, as if to banish doubts about a lack of contingency plan after the procedure. “Definitely, if there’s a readmission surgery necessary, I don’t have the money for that, you know?”

She laughs. “I have no idea what would happen. We’ll just have to cross that route if we come to it.”

• Transgender
• LGBTQ+ rights

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