From man to woman: what happens during and after sex change

Gender reassignment, that is, presenting yourself to the world in a completely new image, has different consequences for people. The fact is that the concept of gender has a normative background. As you know, most people regard deviations from the norm as pathology. There are much fewer of those who see in this the realization and identification of themselves. Of course, it matters what standard we are talking about.

Gender change

First of all, people who changed their gender underwent a large amount of preliminary training. Before the procedures, the patient must undergo hormonal therapy under the supervision of a physician. Hormone therapy lasts approximately one year. For some countries, it is not possible to change gender until a diagnosis of transsexualism is made. Without this diagnosis, no action will be taken.

Several areas of plastic surgery are involved in gender reassignment: • Mammoplasty • Phalloplasty • Vaginectomy • Scrotoplasty • Colpocleisis • Hysterectomy • Metoidioplasty • Salpingo-oophorectomy • Ovariectomy

Lana Wachowski

Former man Larry Wachowski, who together with his brother Andy created the famous film trilogy “The Matrix”. He began to appear in the world as a woman named Lana right in 2003, when the last part was released.

Photo on the right © Shutterstock

Before my sex change I was married. The press, which previously called the directors “the Wachowski brothers,” now ironically called them “sister brothers.”

© Shutterstock

From woman to man

People who have changed their gender from female to male have undergone surgery to remove breast tissue and reposition their nipples. Surgery to remove the breast is called a mastectomy. In the process, breast tissue is removed along with fatty tissue and partly muscle tissue. The surgeon achieves the best resemblance to the male breast. Vaginectomy involves removing the vagina, and with colpocleisis, the vagina is surgically sutured.

To shape the penis, phalloplasty is needed. The essence of the process is to create a penis using surrounding tissues. There are two methods for forming a phallus: 1. The surrounding tissue in the abdominal area is cut off and sutured into the groin area in the form of a stem. 2. The second method is a suitcase handle. To nourish the cut flesh, the tissue was sutured until the healing process took place. It was then cut to form the head.

The first method is most often used, since the second method disrupts tissue sensitivity. The significant difference between metoidioplasty and phalloplasty is the formation of the penis by lengthening the clitoris. Using the clitoris as a material for creating a phallus is a more promising technology. Its properties are very similar to the penis. People who have changed their gender do not feel discomfort, everything is natural and natural.

In hysterectomy operations, the uterus is removed, and it may include complete removal along with the cervix - salpingo-oophorectomy. A hysterectomy is performed after hormone replacement therapy, which takes about five years. Once the shaft of the penis is formed, the construction of the testicles and scrotum is performed - scrotoplasty. An oophorectomy involves removing the fallopian tubes and along with them the ovaries.

Everything that was listed above relates to FtM, that is, to the transformation from woman to man. But there are also the opposite - MtF, where a woman is created from a man.

Related procedures involved in body reorganization: - liposuction; - gluteoplasty, - mentoplasty; - and others.

Hormone replacement therapy

If a guy decides for himself that he wants to become a girl, then his transformation begins with hormone therapy. It is based on female sex hormones. They are taken in different forms: capsules, injections, patches, gels.

First of all, these are those that interfere with the production of testosterone, as well as analogues of female hormones - estrogens and gastrogens. Among the antiandrogens (which block testosterone), the most well-known are cyproperone acetate and spironolactone. Of the estrogens, preference is given to estradiol, which is similar to the natural hormone and its artificial analogues: ethinyl estradiol and estradiol valearate.

Artificial drugs are much more powerful and safer than natural ones. For example, ethinyl estradiol at a dose of 0.035 mg can replace 2 mg estradiol, but it has a narrower spectrum of action than natural estrogens. Therefore, it is recommended to use them together. In addition, they enhance each other's effects.

Among estrogens, utrozhestan in capsules and estrogel in the form of a gel are also used, therapy for which lasts several months. It is then replaced with estradiol valearate.

Taking gastrogens is mandatory. They affect the enlargement of the mammary glands, and also smooth out the psycho-emotional consequences of decreased testosterone. Most gastrogens are produced in combination with estrogens, combining them in one preparation.

As for the well-known progesterone, its use has already been practically abandoned. This is due to the fact that it involves the administration of fairly large doses and causes a number of side effects.

It must be said that all natural hormones are more aggressive than their artificial counterparts. And before, when HRT was based exclusively on them, it caused great health problems and even caused death. Modern drugs are softer and harmless.

It is preferable to start HRT before the onset of puberty. In this case, the body will more organically “mature” according to the female type. This is exactly what model Andrea Pejic did. Her masculine features were minimally expressed.

In adolescence, therapy begins with small doses, gradually increasing them. In adults, the opposite is true: they start with shock dosages, gradually reducing them.

In parallel with hormones, vitamins are also taken, for example, folic acid, ideally multivitamins.

Conditions for the operation

In order to plan gender reassignment surgery, it is necessary to go through several stages of preparation: • Hormone therapy for a period of one year; • Psychiatric examination; • The operation can be performed from the age of 21; • The patient must have a diagnosis of transsexualism.

Before taking such a serious step, the patient must clearly understand what action he is committing and what awaits him in the future. People who changed their gender knew what they were agreeing to; they thought it through carefully first. Rehabilitation after plastic surgery for gender reassignment takes a very long time and is under the supervision of a doctor. The patient needs to adapt to his new appearance. The procedure for gender reassignment is very lengthy and expensive. Its approximate cost is about $16,000 and includes a large number of procedures.

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Photos before and after intimate plastic surgery

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How can you tell from before and after pictures that you are a suitable candidate for surgery? Your labia minora (or inner) are about the same length as your outer (major) labia. The best way to truly determine the length of your lips is to assess their visually noticeable area while you stand in front of a mirror. If your labia minora protrude beyond your labia majora, labiaplasty surgery may make sense. In the examples below, photos taken before and after plastic surgery of intimate areas confirm the positive effect of this aesthetic intervention.

Thus, by looking at the photos before and after intimate plastic surgery, you can understand the reason for your concern. For example, you experience aesthetic dissatisfaction with the appearance of your external genitalia, or you feel that it interferes with sexual activity, exercise, hygiene, daily life or self-confidence. Conclusion - you may be a candidate for intimate surgery. This is an extremely popular procedure in our practice, and patient satisfaction with the results, judging by the reviews, is very high.

Often women, especially from regions neighboring Moscow, are interested in the possible cost of the service. For such cases, we have the opportunity to make an approximate calculation based on the photographs sent (click the “How much does it cost” link below). Almost all of the above interventions were performed by the clinic’s chief specialist.

Reviews about intimate plastic surgery

How much does plastic cost?

Lea T

Brazilian model Lea T, muse of the legendary Givenchy brand, was also born a boy. Leonardo never thought about modeling and dreamed of becoming a veterinarian. His life changed in an instant. The director of the Givenchy fashion house, Riccardo Tisci, persuaded Leonardo to create the image of a girl, instantly making him a star in the fashion world.

In 2012, Lea decided to undergo surgery and change her gender. Despite the fact that she is considered one of the most famous transgender models in the world of high fashion, Lea dreams of one day leaving show business and becoming a veterinarian.

Actress, producer and lawyer Laverne Cox

Laverne Cox is the first transgender person to receive an award nomination in an acting category, having been nominated for an Emmy in 2014.
Such success brought her the role of Sofia Barset in the series “Orange is the New Black.” Laverna herself admits that she started thinking about gender reassignment as a child, at the age of 11. The moral transformation from man to woman was facilitated by the constant ridicule of classmates. And Roderick did not feel comfortable in a male body. Many years later, physical transformation followed.

In a man's body

“Parents did not believe that all this was happening”

Yulia, 42 years old. Born male, she never made a full transition as a transgender woman. Yulia has male documents, but she identifies herself as a woman.

In Soviet times, people gave away things and bought them for growth. Therefore, as a six-year-old boy, I tried on my younger sister’s sundresses, which did not yet fit her. When I did this, I realized that this is exactly how I wanted to look. As a child, according to my mother, I nursed my younger sister like a sister and fed her. From the very beginning I understood that I was a girl. And this sundress became one of the bright spots of my childhood.

Another bright spot was the feeling of guilt - for the fact that I was not like the boys, that I was not interested in men's activities, that I did not want to fight, that I was a bad student, and for many reasons. My parents were at work almost all the time, and I stayed with my grandmother. Every day all my guilt poured out into spanking. My grandmother had an iron hand, and it hit me hard. And since after school I had nowhere to go, I returned home, and she spanked me as much as she could. My parents did not believe that all this was happening and did not protect me.

At first I was naive, like all children, and tried to tell adults about myself. One day I asked to tie bows for me. In response, I was whipped. Another time I tied bows, and they tore them out along with my hair. After that they cut my hair very short

The age of six or seven was a turning point. You could say this was my first detransition. I realized that I had to be strong and learn to pretend to be a boy in order to survive. So I learned not to cry and control myself. I found something I liked - I went with my fishing rod for the whole day away from home to be alone. I hid all the memories of myself as a girl for many years.

Puberty began for me earlier than for other children - at 11 years old. Testosterone had a strong effect on my body, hair began to grow on my body, and my voice began to break. I experienced this very hard. Meanwhile, school passed and I was bored. Afraid of giving myself away, I stayed away from everyone and earned myself the nickname Blue.

By the age of 22-23, I began to come closer to realizing and accepting myself as a girl. At the age of 24 or 25, I first tried to pass a commission to get permission for hormone therapy. However, from the outside I looked like a well-socialized guy. Besides, I understood that I loved girls, and I didn’t want to lie about it.

Photo: Abhishek Chinnappa/Getty Images

The commission refused me with the wording that I have transvestism - the desire to dress up as a woman, and not be one all the time. Then I found information on hormone therapy on the Internet and doctors who were ready to advise me, and began taking hormones at my own peril and risk.

I've read a lot of transition stories. Usually a person gets the desired appearance in six months, but due to the characteristics of my body this did not happen. Experience has shown that testosterone blockers have virtually no effect on me. Even with hormone therapy, my hair continued to fall out, my bald patches increased, and my beard and mustache were actively growing. And still I wore long hair, earrings, high heels and women's clothes. At the same time, I have never encountered direct aggression directed at me. Perhaps because she was confident in herself and always looked people straight in the eyes.

In addition, I wanted to have my own children, to give them maternal warmth and care. For this reason, I did not seriously think about operations. When I was 28 years old and had been taking hormones for four years, I met a girl at work. It was love at first sight. And she wanted to see me as a man...

This was my second detransition. For her sake, I changed everything I could. The male role was familiar to me, but it took on new colors. Even so, playing the role of a man, I could take care of the family like a woman. Conceiving my first child was a surprise for me, because I continued hormone therapy. The birth of my daughter pushed me to understand what exactly could give me a feeling of fullness of life. I spent the next few years finding ways to feed my baby. Six years later, by the time my second child was born—also a girl—I was able to breastfeed.

Of course, I would really like to carry and give birth to a child myself. But science is not ready for this yet, and I am already happy with what I have achieved.

Photo: Juliane Liebermann / Unsplash

I've been married for 11 years. I have a reputation as a wonderful husband and family man. I am respected by my family, friends and colleagues. Without a higher education, I made a very successful career in IT. But time passes, the children grow up, and I understand that life is passing me by and I can no longer see a man in the mirror and play a role that is alien to me.

The turning point happened a little over a year ago, when I turned 41. I went to a psychiatrist just to sort myself out. The psychiatrist was brief: “Until the age of 41, you were not able to get rid of the desire to be a woman, you just have to accept this situation.” According to him, all thoughts and desires undergo natural selection. If this desire had no weight, it would have disappeared long ago.

A year has passed since that conversation. During this year, I invested more than a million rubles in cosmetology, laser hair removal, and permanent makeup. It seemed to me that there was a chance to get what I had always dreamed of. But over time, I become more and more aware that being a woman is not as important to me as being a mother.

After 18 years of hormone therapy and dozens of cosmetic procedures, I still spend about two hours on hair removal, makeup, and a wig. Someone will say that there is surgical cosmetology, but it is contraindicated for me, as is electrolysis. And I ask myself the question: will I be a good mother, taking a few hours from my family every day to become a woman in the eyes of others? Despite having natural size 4 breasts, I was never able to get the figure I wanted. Most women's clothing doesn't fit me. In the mirror in the morning I still see a man.

Photo: Kyle/Unsplash

Voice training never allowed me to achieve a completely feminine sound. All this together leads to the fact that full female socialization becomes too expensive for me and my family. Dear in every sense. Not long ago I decided to go for detransition for the third time in order to preserve everything that I have - first of all, my family and children. Although the children just accept me anyway.

Children know and notice everything. My daughters are well acquainted with Yulia - my feminine self - and call her “mama”. With children everything is very simple. It is important to them that they are loved

I can't say that I'm happy now. I threw away all feminine things and position myself in society as a man, but I continue therapy because the consequences of hormone withdrawal are unpredictable. I don’t know when I will try to complete the transition again and how it will end. But I really hope that society can accept people like me.

Note from Lenta.ru:

Now Yulia (according to documents - Ilya) has decided to return to the male gender again for the sake of her family. She may return to the idea of ​​becoming a woman in the future.

Andrea Pejic

Andrej Pejic always wanted to be a girl. At the age of 17 he got into the modeling business. His unconventional appearance allowed him to show both men's and women's clothing. He even walked in a wedding dress at the Gautier show! Five years ago, Andrei finally decided to undergo gender reassignment and became a girl. Now Andrea is a famous and sought-after model. The girl does not advertise her personal life, but does not hide the fact that she dreams of becoming a mother.

Valentina Sampaio

Looking at the fragile beauty Valentina Sampaio, it is difficult to imagine that she was born a boy. However, instead of football, he was interested in dolls. At the age of 8, her mother took her to a psychologist who helped Valentina accept herself. The model does not say what her name was before, but she recalls that at the age of 12 she heard the name Valentina and began to call herself that.

Valentina has made a stunning career. In 2022, she appeared on the cover of French Vogue. And recently she became the first transgender model of the Victoria's Secret brand.

Actress and performance artist Candis Cayne

Candis Cayne is the first transgender actress.
She managed to receive this “title” in 2007 for her role as the transgender Carmelita in the TV series “Dirty Wet Money.” Brendan McDaniel began gender reassignment at the age of 25, and today he is a famous American actress and performance artist.

In a man's body