Gender reassignment surgery, also known as gender confirmation surgery, is the medical term for a range of procedures that change the physical characteristics of a person’s body to make them more congruent with their gender identity. As the following article explains, gender reassignment surgery is not an exact science and the final appearance of a person’s new body will depend on a number of factors, such as their age and general health. It is also an expensive procedure and a political ‘hot potato' over who should foot the bill.
Gender reassignment surgery or sex reassignment surgery is an umbrella term given to a number of procedures that aim to realign a person’s physical characteristics with their internal sense of gender. It is often the end of a process of transition that begins with superficial changes, such as clothes, makeup and hair and continues with hormone therapy.
Someone who has always felt deep-down to be a woman, for example, but has the physical characteristics of a man, might opt for surgery to remove male biological features and have surgeries giving them more stereotypically feminine features, such as breasts and a vagina. A woman identifying as a man can also have surgery and treatment that will help them to look like a man.
It is important to note that for many trans people, surgery is not part of their journey, and surgery should not be undertaken lightly, not least because of the significant risks and side-effects, as with any surgical procedure. In the UK, for example, gender reassignment surgery is only an option for those who are over 18 and pre-surgery counselling is also a requirement. Other countries have slightly different rules but usually follow a clear principle
Candidates for gender confirmation surgery must always transition socially, and live as their preferred gender identity full-time. Often they will need to wear a wig or hair extension to add a feminine touch. They must have pre-surgery counselling, generally for at least two years, and usually receive hormone therapy for at least six months before surgery. This is a crucial part of the whole debate. Whether a patient is suffering from dysmorphia – a psychological issue – or simply feels that their gender was wrongly assigned at birth. The fact that the LGBT lobby is so powerful has made this subject area very difficult to navigate without risking giving offence.
Gender confirmation surgery is only offered once the person and their care team are sure it is the right choice for them. It’s always good to remember that genitals don’t have genders, people do, and the patient is already the woman, man or non-binary person they’ve always been.
For those who do choose to transition through surgery, there is the whole issue of costs and who pays for the procedure. This does, of course, vary tremendously by country and by the insurance company. There are various surgical procedures that can be undertaken.
Once the surgical pathway is undertaken there are various optional stages.
Gender confirmation surgery for transgender men in the UK may involve:
- removal of the breasts, known as a double mastectomy
- removal of the womb, ovaries and fallopian tubes
Gender confirmation surgery on the chest is commonly referred to as top surgery, while gender confirmation surgery on the genitals is commonly referred to as bottom surgery.
Someone who has always felt like a woman, for example, but has the physical characteristics of a man, might opt for surgery to remove male biological features and have surgeries giving them more stereotypically feminine features, such as breasts and a vagina. A woman identifying as a man can also have surgery and treatment that will help them to look like a man. Other popular surgeries include:
- Chondrolaryngoplasty – this is a shaving of the part of the trachea commonly known as the Adam’s apple, making it less pronounced and less visible.
- Vocal Folds Shortening and Retrodisplacement of the Anterior Commissure’ ( VFSRAC) or voice feminisation surgery – this surgery alters the voice box resulting in a voice that is higher pitched than a man’s.
- There are also many types of facial reconstruction surgeries that modify strongly masculine bone and cartilage structures. These are not usually available on the NHS.
The Cost of Gender Reassignment Surgery
In the USA for example, patients experience numerous roadblocks from insurance companies for gender-affirming procedures and are commonly denied coverage for additional “cosmetic” costs. Meanwhile, cisgender women are able to schedule and receive a breast reduction for their back pain, completely covered by insurance, despite being the same procedure that insurance companies deny members of the transgender community. Insurance companies say that gender-affirming surgery is “medically necessary” and therefore covered, but in the fine print, one finds that a single necessary component of such surgeries can add up to thousands of dollars out of pocket for the patient. These hidden costs are a way of stacking the deck against the transgender and non-binary community without doing so out in the open.
It wasn’t until 2019 that the World Health Organization (WHO) stopped labeling transgender as a gender identity disorder and instead reframed it around “gender incongruence” in a section under sexual health. Studies show how categorizing transgender people as “sick” has contributed to medical and human rights barriers that negatively impact quality of life. This was one of the reasons that WHO decided to amend their health guidelines and policies, hoping to make widespread changes in public perception. While this was a big step for the LGBTQ+ community in the USA and brought about promises of acceptance for transgender people, the institutions that uphold old policies and outdated perceptions inherently influence the rest of society, including the medical field, and it starts way before an insurance company can deny coverage for a nipple graft. Hopefully, the new Biden regime will make the path a little bit easier. Many hope that it will.
in the UK too, changing sex isn't cheap. The cost of gender reassignment is £19,236 per patient, including support as well as surgery. The total cost to the NHS in England lin 2016 was £17.13 million and this year the budget has been increased to £22.72 million.
The good news is that gender reassignment is available on the NHS but the bad news is that there are often long waiting lists, depending on the demand in your area. The average waiting time for sex-change therapy for an adult is approximately 9 months -and this is just the start of the process. In the UK, it is considered good practice for individuals to receive counselling for at least two years before any surgery. Receiving hormone therapy for at least six months is also usually a given. However, this is not set in stone and there are exceptions to every rule. If a trans man, for example, is suffering health issues caused by breast binding, surgery may be offered as an alternative to hormone treatment.
So how can you fund your surgery without going to war with the big insurance companies or institutions such as the NHS?
Get help paying for gender confirmation surgery
Given how expensive gender confirmation surgery can be, paying for it can be tough. So how can you pay to cover top or bottom surgery costs privately?
Take out a loan
Taking out a loan is quick to do, but be wary as high-interest rates could lead to financial problems down the line.
Reach out to a charity
Charitable organisations may be able to provide you with some financial assistance in the form of a medical grant.
Organise a rainbow dress-up day
One of LGBTQ+ charity Stonewall’s top fundraising ideas is to organise a rainbow dress-up day at your workplace. Talk to your employer about your plans for gender confirmation surgery and rally support from your colleagues. The idea is that everybody swaps their boring office attire for an outfit in all the colours of the rainbow, in a nod to the well-known LGBTQ+ flag, in exchange for a donation to your cause.
Host an LGBTQ+ movie night
Encourage friends to donate by hosting a big night in complete with movies, popcorn and a floor full of duvets.
Throw a fundraising party
Your local LGBTQ+ nightclub could make the ideal venue for a fundraising party, especially if you offer them a cut of your proceeds. Consider asking any LGBTQ+ groups you’re involved with whether members could spare some time to help you sell tickets, book some entertainment and/or organise a raffle.
Try your hand as a quizmaster
Fundraising over a drink or two is hard to beat. Get in touch with your local pub about hosting a quiz there one night. Explain why you’re fundraising and see if they’d be willing to donate a prize for the winner in exchange for you promoting the event and bringing people their bar.
Raise funds by asking people to donate as much as they can in place of the usual quiz entry fee. Throw in a few questions about trans issues, language and equality – your quizzers will learn and have fun at the same time.
Crowdfunding
Thousands of transgender people have successfully set up crowdfunding campaigns on sites such as GoFundMe to help raise funds for treatment.
In 2019, a transgender man called Jude smashed his £1,200 crowdfunding target, allowing him to travel to Poland for top surgery. “My whole life, I’ve detested the body I live in,” he wrote on his GoFundMe. “It feels like a cage. It feels monstrous. Jude isn’t the only one who had success crowdfunding. Laura met her £550 goal to raise funds to cover her initial appointment fee and travel costs, while Mia raised nearly £5,700 for facial feminisation surgery.
Many clinics around the world specialise in GRS but with the travel constraints of COVID-19 many of these options have vanished for the moment. Our list of specialist surgeries may no longer be up to date but it should provide a start for you if you are exploring the treatment options.
1. Chettawut Plastic Surgery Center, Bangkok Thailand
This is a 'goto' clinic for Gender Reassignment Surgery (GRS). Dr. Chettawut Tulayaphanich is regarded as one of the great surgeons in this controversial area of cosmetic surgery. With almost 3,000 cases in Sex reassignment surgery and Facial feminisation surgery with satisfactory outcomes. They even offer voice surgery to change a low pitch (Male voice) into a higher pitch pattern with natural voice quality. If you are looking for gender transition surgery this clinic will be high on your list
Address
1529/4 Onnut 31 Sukhumvit 77 Bangkok, Thailand 10250
Phone
+(669) 5650-3892
Checklist
Procedures Offered
- Gender Reassignment Surgery
Does Your Clinic Offer Special Packages?
See website for any special packages
2. Sava Perovic Foundation Surgery Belgrade Serbia
This clinic is dedicated to genitourinary surgical procedures and ia a European frontrunner in gender reassignment surgery. They are are also highly geared to the medical tourism market with a deep understanding of the needs of the travelling patient. A visit to their website will show you the wide menu of reconstructive and transformative surgeries on offer. If you are searching for this type of surgery you will be reassured by their services.
Address
Sava Perovic Foundation
Belgrade, Serbia
Phone
+1 (216) 220-4220
Checklist
- Airport Pickup
- Hotel Booking
- Private rooms for patients
- Medical records coordination
- Interpeter & translation services
Procedures Offered
- Gender Reassignment Surgery
Does Your Clinic Offer Special Packages?
See website for packages
3. Cosmetic Surgery Partners
A London based cosmetic surgery clinic led by world class Cosmetic Surgeons
Cosmetic Surgery Partners (CSP) was formed in November 2010 by Nick Percival, Dai Davies and Miles Berry. It is a London based Cosmetic Surgery Clinic owned by Cosmetic Surgery (UK) Ltd. It continues to be managed by leading UK specialist cosmetic surgeons.
Cosmetic Surgery Partners was born from Plastic Surgery Partners, a partnership formed in 1998 by Nick Percival and Dai Davies, two Consultant Plastic Surgeons who w
Address
The London Welbeck Hospital
27 Welbeck Street
London
W1G 8EN
Phone
442074866778
Checklist
Procedures Offered
Liposuction
Breast Augmentation
Breast Reduction
Breast Lift
Blepharoplasty (eyelids)
Abdominoplasty. (tummy tuck)
Rhinoplasty (nose job)
Non-surgical Nose Job
Forehead Lift
Otoplasty (ear correction treatment)
Thigh and Buttock Lift
Rhytidectomy (Facelift)
Gynecomastia (male breast reduction)
Labiaplasty
Cosmetic Surgery Packages Available
4. Phuket International Aesthetic Centre (PIAC) Thailand
This is a medical tourist's dream location on the fabulous island of Phuket and a renowned clinic to make a gender reassignment surgery. In addition to GRS they offer a comprehensive range of plastic surgery and cosmetic procedures all aimed at reshaping appearance and improving lifestyles, performed by internationally recognised plastic surgeons._thailand_1588247660.png)
Address
Phuket Plastic Surgery Institute
Bangkok Hospital Siriroj
44 Chalermprakiat Ror 9 Rd, Phuket 83000 Thailand
Phone
+ 0 76 361 888
Checklist
Procedures Offered
- Breast Augmentation
- Breast Reduction
- Breast Lift
- Blepharoplasty (eyelids)
- Abdominoplasty. (tummy tuck)
- Rhinoplasty (nose job)
- Otoplasty (ear correction treatment)
- Thigh and Buttock Lift
- Rhytidectomy (Facelift)
- Gynecomastia (male breast reduction)
- Labiaplasty
- Hymen Repair
- Gender Reassignment Surgery
Does Your Clinic Offer Special Packages?
See website for any offers.
5. Rumer Cosmetic Surgery. Ardmore USA
Dr. Kathy Rumer is a leading aesthetic and reconstructive plastic surgeon with a private practice on Philadelphia’s Main Line. Board-certified in plastic surgery, Dr. Rumer’s practice offers state-of-the-art procedures, cutting edge product offerings, and innovative technologies that achieve the maximum results for her patients. This is a top place for gender reassignment surgery. Her reputation is unparalleled in the field so you can put her high on your list. 
Address
105 ARDMORE AVE
ARDMORE, PA 19003
USA
Phone
+ 1(855) 782-5665
Checklist
Procedures Offered
- Liposuction
- Breast Augmentation
- Breast Reduction
- Breast Lift
- Blepharoplasty (eyelids)
- Abdominoplasty. (tummy tuck)
- Rhinoplasty (nose job)
- Non-surgical Nose Job
- Forehead Lift
- Otoplasty (ear correction treatment)
- Thigh and Buttock Lift
- Rhytidectomy (Facelift)
- Gynecomastia (male breast reduction)
- Labiaplasty
- Hymen Repair
- Gender Reassignment Surgery
Does Your Clinic Offer Special Packages?
6. Center for Transgender Medicine & Surgery New York USA
CMTS in New York is a byword in the transgender community. ave expertise in primary care, hormone therapy, behavioral health support, gender-affirming surgeries, and other supportive services. Thus, patients at CTMS can receive primary care, as well as see specialists in the areas of endocrinology, behavioural health, plastic surgery, urology, gynaecology, and more.
Address
275 Seventh Avenue, 12th Floor
New York, NY 10001
Phone
+112-604-1730
Checklist
Procedures Offered
- Gender Reassignment Surgery
Does Your Clinic Offer Special Packages?
7. Preecha Aesthetic Institute (PAI Clinic) Bangkok Thailand
This excellent clinic first established in 1977 and has been consistently the best and most highly thought of SRS clinic in Thailand. Dr Preecha (not yet retired), still actively practices with his skilled team, he lectures and teaches various transgender procedures worldwide, whilst leading a selected group of highly skilled surgeons to provide the highest quality SRS. FFS and other related surgeries at his clinic. _1589132788.png)
Address
PAI (Preecha Aesthetic Institute)
898/1 Sukumvit Soi 55 (Thong Lor)
Wattana, Bangkok, 10110 Thailand
Phone
(662)715-0111
Checklist
- Airport Pickup
- Hotel Booking
- Private rooms for patients
- Accessible rooms
- Family accommodation
- Free Wifi
- Phone in room
- TV in room
- Special dietary requests
Procedures Offered
- Liposuction
- Breast Augmentation
- Breast Reduction
- Breast Lift
- Blepharoplasty (eyelids)
- Abdominoplasty. (tummy tuck)
- Rhinoplasty (nose job)
- Non-surgical Nose Job
- Forehead Lift
- Rhytidectomy (Facelift)
- Gynecomastia (male breast reduction)
- Hymen Repair
- Gender Reassignment Surgery
- Hair Transplant Surgery
Some Recent Reviews from Google.
Does Your Clinic Offer Special Packages?
- Competitive prices
8. Kamol Hospital
Kamol Clinic in Bangkok is a top destination for transgender surgery They have worked with many trans celebrities - many of whom are pleased to be associated with them on their website. This clinic is a good example why many trans people travel to Thailand for sex change work.
Address
Kamol Hospital - Cosmetic & Plastic Surgery 1223 Ladpraw 94 Intraporn Rd. Wangthonglang Bangkok 10310, Thailand
Phone
+662 559 0155
Checklist
- Airport Pickup
- Hotel Booking
- Private rooms for patients
- Medical records coordination
Procedures Offered
- Gender Reassignment Surgery
Some Recent Reviews from Google.
I will come back here again next year to continue my transition(FTM). Juthamard Promchana
Does Your Clinic Offer Special Packages?
9. Elysian Plastic Surgery Texas USA
Dr Dellinger is well known for his work in MTF breast surgery and also in male penis enlargement and hormone treatments. Additionally his clinic in Austin Texas does the usual range of cosmetic operations. Dr. David Dellinger is an accomplished surgeon double-board certified in both Plastic and Reconstructive Surgery as well as General Surgery. In practice since 1997, Dr. Dellinger has performed thousands of procedures in his career. 
Address
11623 Angus Rd, Ste C15
Austin, Texas 78759
Phone
+1(512) 229-1978
Checklist
- Airport Pickup
- Hotel Booking
- Private rooms for patients
- Medical records coordination
Procedures Offered
- Liposuction
- Breast Augmentation
- Breast Reduction
- Breast Lift
- Blepharoplasty (eyelids)
- Abdominoplasty. (tummy tuck)
- Rhinoplasty (nose job)
- Non-surgical Nose Job
- Forehead Lift
- Otoplasty (ear correction treatment)
- Thigh and Buttock Lift
- Rhytidectomy (Facelift)
- Gynecomastia (male breast reduction)
- Labiaplasty
- Hymen Repair
- Gender Reassignment Surgery
- Male Penis Enlargement
Some Recent Reviews from Google.
Does Your Clinic Offer Special Packages?
There is a ‘specials’ tab on the website.
10. 2Pass Clinic Antwerp Belgium
This Belgium based trans specialist clinic has a fine reputation in helping transgender candidates move smoothly into a female role. They offer an integration service for finishing touches such as make-up classes. And all is conducted by a team of highly-qualified practitioners, nurses, and beauticians who practice this day in and day out. We offer body and face feminisation procedures for transgender patients in Antwerp.
Contact initially by email only.
Address
Ringlaan 51
2600 Berchem (Antwerp)
Belgium
Phone
Checklist
- Airport Pickup
- Hotel Booking
- Skype Consultations
- Private rooms for patients
- Medical records coordination
Procedures Offered
- Gender Reassignment Surgery
Some Recent Reviews from Google.
Does Your Clinic Offer Special Packages?
Admin is Blogger David Miller FRSA. M.Sc A respected British journalist based in Helsinki Finland. David's portfolio is at http://livewire.pressfolios.com/ David is contactable via the site or at david@dmiller.co.uk
