Sex Reassignment Surgery in Thailand
What is Sex Reassignment Surgery?
Sex reassignment surgery (SRS) is a medical procedure offered at our clinic in Bangkok, Thailand. Also known as gender affirmation surgery, SRS involves surgical procedures that transform an individual’s physical characteristics to align with their gender identity. This surgery is critical for transgender individuals seeking to resolve the distress caused by a mismatch between their gender identity and physical appearance.
At Nirunda Clinic, SRS encompasses procedures for both male-to-female (MTF) and female-to-male (FTM) transitions.
What is MTF Surgery?
Male-to-female (MTF) sex reassignment surgery in Thailand involves transforming male genitalia into female genitalia. This surgery can significantly improve the quality of life for transgender women, helping them feel more comfortable and confident in their bodies. People who are transgender often feel they’re living in a body that doesn’t match their true gender identity. This surgery aims to alleviate this discomfort by creating a physical appearance that aligns with the individual’s gender identity.
(Male-to-Female) Penile Inversion: Are You a Good Candidate?
- Patients must be at least 18 years old, and patients under 20 must have their parent or guardian’s signed permission on the consent form.
- By Thai law, patients must have the approval from two Thai psychiatrists and be diagnosed with at least one of the following disorders: gender identity disorder, gender dysphoria, or associated conditions, before undergoing surgery.
- Patients must have undergone at least one year of antiandrogen and female hormone treatment. They must also have completed a period of living full-time in their desired transgender role to be eligible for the surgery.
Types of MTF Penile Inversion
There are three different kinds of penile inversion procedures:
- Long Penile (> 6inches): Involves penile skin inversion
- Medium Penile (2 – 6 inches): Involves penile skin inversion with scrotal skin graft (SSG)
- Short Penile (< 2 inches): Involves penile skin inversion with sigmoid colon flap (SCF)
The MTF Surgical Procedure
In our Bangkok clinic, the MTF sex change surgery begins with creating the vaginal cavity between the urethra, prostate, bladder, and rectum. The surgeon will cut out both sides of the scrotal, peel out the skin of the penile shaft, and invert it to form the vaginal lining. The glans penile with two dorsal nerves and vessels are preserved to create space, setting the position of the sensate clitoris. Then, urethroplasty and labiaplasty are done, where the excess skin erectile tissue around the urethra will be removed to avoid engorgement during sexual arousal. The next steps are wound packing with gauze bandage, blood drainage, and placement of a urine catheter.
Preparation Before Operation
The required documents must be submitted to our clinic one month before your MTF surgery. In Thailand, we follow the Harry Benjamin International Gender Dysphoria Association (HBIGDA) criteria for eligibility and readiness, which indicates that a patient should:
- Obtain two letters recommending the SRS from a therapist, psychiatrist, endocrinologist, or general practitioner.
- To reduce the risk of blood clots, stop hormone treatment at least 2 weeks before surgery. Oral tablets should be stopped 2 weeks before surgery, and injectables 4 weeks before surgery. Oral antiandrogen should be stopped 3 days and injectables 4 weeks before surgery.
- Undergo a physical check-up within 3 months before surgery to confirm you don’t have serious medical conditions that are high risk for major surgery. Patients must pass the following blood tests: CBC, anti-HIV, electrolytes, blood sugar, bun, creatinine, alkaline phosphatase, chest X-ray, ECG, SGOT, and LDH.
- Avoid smoking and taking aspirin, anticoagulants, ibuprofen, and vitamin E at least 10 to 14 days before surgery.
- HIV patients are accepted but incur an additional 30% cost for disposable instruments.
Sample of a Sex Change Surgery Schedule at Nirunda Clinic in Bangkok
- Day 1: Arrive in Bangkok
- Day 2: Clinical interview, medical documentation check, hospital admission, preoperative preparation, general anesthesia, and surgery (5-6 hours, depending on the surgery type).
- Day 3-5: Post-surgery recovery with monitoring and pain management
- Day 6: Removal of packing bandage and catheter
- Day 7-14: Rest and recovery
- Day 15: Light activities allowed
- Day 16: Stitches removal and final examination
- Day 17: Departure from Bangkok
Results and Follow-Up
After surgery, you should stay in Bangkok for at least 10 to 14 days and then take time at home for about 4 to 6 weeks to recover before going back to work.
The results of the surgery are visible almost immediately. However, it may take several months for the final results to fully develop. You may experience numbness and a firm feeling over the skin’s surface, which will resolve over time, and it may take a year or more for incision lines to refine and fade to some degree. Although permanent, these lines can usually be hidden by most clothing and swimsuits.
What is Facial Feminization Surgery (FFS)?
Facial Feminization Surgery (FFS) is a set of procedures designed to transform masculine facial features into a more feminine appearance. This surgery can include a variety of procedures, such as forehead contouring, rhinoplasty, and jaw reshaping.
Who are Candidates for FFS?
Ideal candidates for FFS are transgender women or non-binary individuals looking to soften their facial features to align with their gender identity. It’s important to have realistic expectations and be in good overall health before undergoing these treatments.
FFS Procedures
FFS can involve multiple procedures tailored to each individual’s needs, including:
- Forehead Contouring: Reshaping the forehead to reduce the prominence of brow ridges and create a smoother, more feminine contour.
- Rhinoplasty: Reshaping the nose to achieve a more refined and feminine appearance.
- Cheek Augmentation: Enhancing the cheeks with implants or fillers to create a fuller, more feminine look.
- Lip Lift and Augmentation: Shortening the upper lip to reveal more of the teeth and increasing the fullness of the lips.
- Jaw and Chin Reshaping: Contouring the jawline and reducing the size of the chin to create a softer, more delicate appearance.
- Tracheal Shave (Adam's Apple Reduction): Reducing the size of the Adam’s Apple to achieve a smoother neck profile.
Sex Change Operation by Dr. Poonpissamai
Dr. Poonpissamai Suwajo is a distinguished plastic surgeon specializing in sex reassignment surgery at Nirunda Clinic. With an impressive academic background and extensive experience, Dr. Poonpissamai is committed to delivering exceptional care and results for her patients.
Dr. Poonpissamai is a Doctor of Medicine graduate of Chulalongkorn University, where she is now a lecturer. She is also a member of the Thai Board of Plastic and Reconstructive Surgery at King Chulalongkorn Memorial Hospital. She completed her fellowship in General Surgery at Khonkaen University’s Srinakharind Hospital.
With Dr. Poonpissamai’s expertise and experience, we’re proud to offer sex reassignment surgery at Nirunda Clinic in Bangkok, Thailand. Book a consultation at our Bangkok clinic to discuss MTF surgeries, such as penile inversion, facial feminization surgery, and labiaplasty, and to learn more about the procedures and costs in Thailand.
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