Female to Male Surgery In Thailand 

Female-to-male (FTM) gender affirmation surgery is a detailed, multi-step procedure aimed at changing female primary and secondary sexual traits into masculine characteristics. Individuals diagnosed with Gender Identity Disorder, now more frequently identified as gender dysphoria, typically pursue this surgery to align their physical appearance with their gender identity. The full process can extend over a year or longer, with different stages spaced out by 3 to 6 months.

Stages of FTM Gender Affirmation Surgery

Stage 1: Mastectomy and Hysterectomy

Mastectomy:

  • Purpose: Eliminates breast tissue to a more masculine chest shape.
  • Techniques: The method used varies depending on the amount of breast tissue and skin available. Options consist of periareolar or double incision techniques, tailored to the patient’s anatomy.

Total Abdominal Hysterectomy with Bilateral Salpingo-Oophorectomy (TAHBS):

  • Purpose: Removes internal female reproductive organs, including the uterus, fallopian tubes, and ovaries.
  • Reason: This operation stops menstruation and eliminates the possibility of pregnancy, often conducted to halt estrogen production.

Stage 2: Vaginectomy, Urethral Lengthening, and Urethral Prefabrication

Vaginectomy and Urethral Lengthening:

  • Purpose: Eliminates the vaginal cavity and extends the urethra to facilitate urination while standing.
  • Procedure: The vaginal canal is sealed off, and the urethra is lengthened in preparation for its future integration into the newly formed penis.

Urethral Prefabrication:

  • Purpose: Sets up a new penile urethra using a graft, commonly taken from the forearm.
  • Procedure: A catheter is inserted into the graft, which will later serve as the functional urethra within the constructed penis.

Stage 3: Total Phalloplasty

Phalloplasty:

  • Purpose: Creates a penis using a graft, typically harvested from the forearm in the previous stage.
  • Procedure: The graft is moved to the genital region, carefully preserving nerves and blood vessels to maintain sensation. The constructed penis will function as a urinary organ and can achieve penetration during intercourse with the use of an erectile prosthesis.

Scrotoplasty:

  • Purpose: Forms scrotal sacs from the labia majora.
  • Options: Patients may choose to have prosthetic testes implanted during a follow-up procedure.

Special Requirements for FTM Surgery

To qualify for FTM surgery, individuals must fulfill certain medical and psychological conditions:

Legal and Health Requirements:

  • Legal Age: Must be of legal age.
  • Health Status: Should be in good health.

Documentation:

  • Psychiatric Recommendations:
    • From Two Psychiatrists: One from the patient’s local area and another from the surgical team.
    • Content: Must confirm a diagnosis of Gender Identity Disorder, establish that the patient has lived as a male for at least one year, and fulfill the criteria set by the Harry Benjamin International Gender Dysphoria Association.

Hormone Therapy:

  • Medical Certificate: Required to show proof of male hormone therapy.
  • Duration: Must have undergone hormone therapy for a minimum of one year, prescribed and overseen by a licensed medical professional.

This method aims to ensure that individuals are fully prepared and supported during their transition, both physically and mentally. Specialized surgeons with expertise in gender-affirming surgeries carry out these procedures, often in countries like Thailand, where a high level of skill and experience is available for such complex operations.