The Gender-Affirming Surgery Process & Where to Have It Done

If you’re considering gender-affirming surgery, it’s important to understand what the process involves and where to get expert care. This article will walk you through the key steps of male to female and female to male surgeries, how to prepare, and why Nirunda International Aesthetic Clinic is a trusted provider of MTF surgery in Thailand.

What Is Gender-Affirming Surgery?

Gender-affirming surgery or sex reassignment surgery refers to a range of medical procedures that help align an individual’s physical characteristics with their gender identity. These surgeries include top surgery or chest reconstruction, bottom surgery or genital reconstruction, and facial surgeries. Each treatment plan is unique and is based on each patient’s personal goals, health status, and readiness.

Reasons for Gender-Affirming Surgery

Individuals seek gender-affirming surgery for various reasons, such as physically aligning with their gender identity and reducing gender dysphoria. They seek to live more authentically and comfortably in their bodies and improve their mental well-being and confidence. The procedures undertaken during sex reassignment surgery are performed to improve the quality of life and emotional health of the patient.

What Are MTF and FTM Surgeries?

Gender-affirming surgery can be categorized broadly as MTF or male-to-female surgery and FTM or female-to-male surgery.

Male-to-Female Surgery (MTF)

MTF surgery helps individuals assigned male at birth transition to a female body. Common procedures include:

• Vaginoplasty: The creation of a functional and aesthetic vagina, most often performed using penile inversion or, in some cases, rectosigmoid vaginoplasty, where a segment of the colon (sigmoid colon technique) is used.
• Breast Augmentation: Placement of breast implants to create a feminine chest contour if hormone therapy alone doesn’t result in sufficient breast growth.
• Facial Feminization Surgery: FFS is a set of procedures to soften facial features, such as brow reduction, jaw contouring, rhinoplasty, or tracheal shave (Adam’s apple reduction).
• Body Contouring: Liposuction and fat grafting are performed to achieve a more feminine silhouette.

Female-to-Male Surgery (FTM)

FTM surgery supports those assigned female at birth in transitioning to a male body. Common procedures include:

• Top Surgery (Chest Masculinization): This procedure involves the removal of breast tissue to create a flat, masculine chest.
• Metoidioplasty: Uses hormonally enlarged clitoral tissue to construct a neophallus. 
• Phalloplasty: Construction of a penis using tissue grafts, typically from the forearm or thigh, often combined with urethral lengthening and scrotoplasty or scrotum reconstruction.
• Hysterectomy and Oophorectomy: Removal of the uterus and ovaries to stop menstruation and eliminate internal female anatomy.

Each surgical plan is highly individualized based on the person’s goals, anatomy, and health history. At Nirunda Clinic, our specialist surgeons work closely with patients to discuss all options thoroughly to ensure safe and optimal results.

Gender-Affirming Surgery Process

Patients must be at least 18 years old, undergoing psychiatric evaluation, and be diagnosed with gender dysphoria. Transitions from male to female or female to male through surgery involve several steps:

Consultation and Readiness Assessment

A comprehensive evaluation with a plastic surgeon helps determine your goals, overall health, and eligibility for different procedures, according to the criteria of the World Professional Association for Transgender Health (WPATH).

Mental Health Evaluation

Recommendation letters, including psychological evaluations from mental health professionals confirming gender dysphoria and readiness for surgery, are typically required.

Hormone Therapy

While not mandatory for all, many patients undergo hormone therapy before surgery, especially for male-to-female transition cases, to aid in body contouring and psychological adjustment.

Pre-Surgical Preparation

Pre-surgery, patients must undergo laboratory tests and get medical clearance. Their doctor will recommend a plan to prepare for surgery, which usually involves stopping smoking or certain medications and hormone therapies, weight management, and other lifestyle adjustments.

Surgery Procedure

This is the main procedure, involving the reshaping or creation of new structures based on the chosen procedures and the patient’s specific needs.

Post-Operative Care and Follow-Up

Post-surgery involves wound care and pain management. Confinement, if needed, takes 3 to 7 days, depending on the procedure. Most surgeries have an initial downtime of 2 to 4 weeks. The patient’s condition will be closely monitored for potential complications. Full recovery usually takes 3 to 6 months, with follow-up check-up appointments scheduled to ensure a smooth recovery.

What to Look for in a Gender-Affirming Surgery Clinic

When choosing a provider, look for board-certified plastic surgeons with documented experience in gender-affirming surgery procedures, such as those at Nirunda Clinic. Be sure to research the clinic’s proven patient results and positive reviews. Choose a clinic with a multidisciplinary team, including mental health and endocrinology experts. It should also have strict medical safety standards and cutting-edge technology in a safe, clean, and hygienic environment. 

Specialists must provide personal consultations to determine a transition plan, provide clear pre-procedure and post-procedure protocols to ensure, and offer aftercare plans, including follow-up visits, wound care, and recovery support. Consider a clinic with caring, multilingual staff that prioritizes your comfort. If you’re considering gender-affirming or transgender surgery, learn the process and what to expect from the experts at Nirunda Clinic in Bangkok. Book a consultation today.

References:

New Legal Framework for Transgender Individuals in Thailand. Retrieved on 17 July 2025 from: https://lovefoundation.or.th/en/legal-transgender-in-thailand/

Gender Affirming Surgery Handout. Retrieved on 17 July 2025 from: https://wpath.org/wp-content/uploads/2024/11/WPATH-HPP-Surgery-for-Handouts.pdf