What is the Sex Change Surgery?

Sex change surgery refers to the administration of surgery to change the sex appearance according to one’s sex identity. There are two kinds of surgery.

When is SRS performed?

The time that people start feeling of belonging to the opposite sex is 2-3 years of age. According to the outcome of many researches, early treatment would prevent unnecessary sufferings. Physical outcome of an early treatment can be expected to be more satisfactory by comparison with starting later, especially MFs (male to female). This is an enormous and lifelong advantage instead of having to live with a deep voice and other scar. Thus, the earlier the SRS is performed, the easier transsexuals can adjust themselves according to their sex identity, and they can avoid the confusion about themselves. But SRS is usually performed at the age of 18-21. There are two reasons for this long delay. First, most children with gender identity disorder will not grow up to become transsexuals. Second, adolescents in many countries are still legally dependent on the consent of their parents when deciding on medical treatment.

How does transsexuals feel after SRS?

On the whole, most of the transsexuals who have performed SRS were satisfied with sex change itself. Nevertheless, many of them were dissatisfied with the way their new physical Appearance. The reason for dissatisfaction is first, MFs have to do with retention of bodily features and aspects of the overall appearance that could not be changed completely by either surgery or hormonal manipulation. For example, remains of the beard, large feet and hands, quality of the voice, and persistence of Adam’s apple. Social pressure on woman to pay more attention to their appearance is also one of the reason. FM transsexuals are usually dissatisfied with their new genitals. But, the most important thing is that they could live in the new gender role feeling that their identity is fitting to themselves. They have more comfortable relationship with other people around their environment.

The procedure, technique and result

1.“Penile inversion technique”vaginoplasty (not good candidate for a case more than 200 lbs. and need more depth)
Surgeon uses the "Penile Inversion Vaginoplasty" technique which turns the penile skin "inside out" and uses it to line a vaginal cavity. The penis and testes are removed. A pure penile inversion limits the size of the vagina that can be created depends on the amount of penile skin available,also the vaginal depth is to depend on penile skin on the resting state not from your erectile state.This technique is called SRS with penile inversion vaginoplasty. You should know the depth hase been gained from your penile skin but not from your whole shaft of penis in resting stage not from your erectile stage.This technique will gain fast recovery and better healing.

2."Scrotal Graft Technique" Vaginoplasty
Some patient's penile tissue limit because the length of penis or the Peno - scrotal junction stays in high position, which will limit the vaginal lining or meaning that vaginal depth is limited.The surgeon will use "Scrotal Graft Technique" combination with penile skin to form the vaginal lining to create the new vaginal depth or new vagina, which is a better technique compared to the penile inversion technique.You will get the depth of your new vagina between 5-7 inches owning to your body structure. This is better choice for the case who have limit penile skin but they have more scrotal sac tissue to use.

Most surgeons currently prefer Scrotal skin graft much more than penile inversion and colon graft.

3."Sigmoid Colon-Vaginoplasty Technique" Vaginoplasty( it is not good case for weight over 200 lbs and larger abdomen.)

You will have two choices to do this surgery about delayed or immediate “ Sigmoid Colon-Vaginoplasty Technique” .Or in case of your penile skin is very short and small amount of your scrotal tissue and refuse to get other skin for grafting to line in your vaginal canal or limited in occasionally rare for some cases with healthy and body weight not over 200 lbs with stopping smoking at least 2 weeks before surgery or non smoking person with flat tummy may need to perform "Sigmoid Colon-Vaginoplasty" do in one stage( Immediate) . In some cases that it will be not appropriate cases to do this procedure ,they have been done by this technique in second step after 6 months(delayed technique) such as the case is not bigger tummy , the weight is over than 200 not more than 225 lbs or maybe need to do this surgery later after 6 months.
In the delayed type,it is better for some cases that have ever done before SRS c Penile inversion or Scrotal skin graft with vaginal shrinkage by the time or for some reason that and need to gain more depth with natural lubricant or they ever had overweight and can not do immediately but they will do later.

All of the cases ,I will construct the labia majora , sensated Labia minora, clitoral hood and sensated clitoris in the meantime. The surgeon also constructs labia majora and labia minora by using some part of your scrotal and sensated prepuce to create this part of female appearance.I don’t use the delayed type for this procedure.You will gain natural labia major and minora on this occasion.The surgeon constructs a clitoris by retaining a small section of the glans penis with its blood supply and nerves intact, and position this into an appropriate site above the urethral meatus. Since the nerves of glans in phenotypic male are analogous to the nerves of the clitoris in a female which patients can have feeling of erotic sensation like naturally – born female and maybe having this arousement sensation to reach orgasm in some case but I can not guarantee that in all of the cases,this is the special sense.