The other day at dinner I commented out of anger due to pain from time of the month that I wanted to be a man. My male dinner companion quipped, “It’s not too late! You can do it anytime; there’s lots of surgery options!” I was a bit taken back by this as usually my Viking just groans and nods whenever I complain like this. Anyhow, I decided to look into it and see what is involved.
The official term is sex change or gender reassignment surgery when one decides to change their gender. There are usually 2 reasons for this: 1) babies are born with intersex deformities, so their sex is decided by the parents and surgery is done or 2) people believe that they are physically a different sex mentally and emotionally. There is also the unofficial reason #3 of people being exploited for the sex business, but all the sites I found were for people who want to do it on their own. Stats are difficult to come by as many surgeries are done in private clinics. Surgeryencyclopedia.com estimates that annually in the US 100-500 people have such surgeries and the number worldwide is estimated to be two to five times larger.
TSSurgeryGuide.com outlines a number of steps for either female to male or male to female surgeries required. Before some of these surgeries, extensive planning is required, such as scheduling multiple doctor appointments; dealing with family, friends, work; insurance; legal documents; taking time for recovery from surgery, etc. Transsexualroadmap.com offers tons of advice and financial calculator for those serious about change.
Male to Female (MTF) Surgeries
Breast Augmentation
Labiaplasty
One Stage MTF SRS/GRS – vaginoplasty
Orchiectomy -removal of the testicles
Tracheal Shave – Adam’s apple shaving
Female to Male (FTM) Surgeries
Hysterectomy
Ring or Simple Metoidioplasty – constructing the penis
Testicle Implants
Top Surgery – Chest reconstructive surgery
Male to Female (MTF)
Other than surgery, according to someone named “Clones Don’t Have 200k Pts” on Yahoo answers who made the transition from man to woman, there are a number of other things needed. Their transition cost about $80,000 USD:
- Therapy. Sessions run $100-150/hr. At least a couple dozen sessions.
- Facial hair removal. Done with electrolysis, laser or a combination of both. Electrolysis can cost $50-80/hr and between 150-300 hours is required to be hair free.
- Body hair removal. Many people need laser treatment to help reduce excess body hair still left after starting hormones.
- Endocrinologist. This doctor evaluates health, prescribes hormones, monitors progress and orders labwork to check hormone levels and liver function. Average cost per visit (with labwork): $500.
- New Clothes. Cost depends on person’s fashion sense.
- Legal fees for legal name change. New Birth certificate. New passport. Costs vary.
- Facial surgery. Facial Feminization Surgery, the most expensive part of transition. Usually $20,000-45,000.
- Breast augmentation. About $6-8,000.
- Sex reassignment surgery. Costs vary, North America ($18,000-20,000) or overseas ($8,000-15,000).
Historically, one of the first recorded surgeries took place in the US in 1962. For those that aren’t queasy, it is amazing what kind of female organs can be created – medical diagrams and pictures are on this vaginoplasty site.
Female to Male (FTM)
Surgeryencyclopedia.com states that female to male reassignment surgery can exceed $50,000 USD while male to female reassignment is $7,000 to $24,000 USD. I’m guessing that female to male is more expensive due to removal and reconstruction of so many things (taking out uterus, making penis, creating broader torso, etc). Also, female plastic surgery in general is more common than male plastic surgery, so there is most likely better competitive pricing. Other items cost relatively the same (therapy, legal changes) and overall estimates I’ve read about online roughly total $80,000 USD as well, same as male to female. Medical pictures of these surgeries are outlined in a scientific paper published in Seminars in Plastic Surgery journal and surgery recovery time from penis reconstruction is stated to be about 2.5 weeks. This is only recovery time for one surgery, for multiple surgeries, times for recovery would vary.
And Then?
For the rest of their lives, people who change gender will need to continue taking hormones to counteract their “natural” ones. In an article published in Archives of sexual behavior, researchers studied 32 male-to-female and 23 female-to-male post surgery and found that female-to-males seem to have better sex lives. Generally, people’s expectations were met at an emotional and social level, but only 80% reported improvement of their sexuality.
What if you regret surgery?
Apparently it’s possible to go back…just do it all over again! A British millionaire named Sam Hashimi became Samantha Kane and then became Charles Kane. Dailymail UK interviewed him and apparently he is happier as a man now. Granted, going back and forth isn’t very good for the body as there is probably some consequence such as desensitization to certain areas due to nerve damage, etc. There are a number of other stories of regret online as well in which people become miserable for the rest of their lives as they suffered from bad surgeries or just changed their mind, but couldn’t go backwards for some reason.
Gender is a complicated issue and there are no easy solutions if one feels like they are suppose to be another sex. For those who actually do take all these steps to fulfill their dream of becoming a man or woman, they are super brave! Kudos to them! I hope they find happiness after all these challenging steps. In the future, would these surgeries become easier? It’s hard to say, cutting into flesh seems painful regardless.
When I was joking with my Viking that if I get a penis it would be bigger than his, he nodded with raised Spock eyebrows and said, “Of course, dear”. Hm, I guess this is what he means when he claims that I test/torture him everyday! Anyhow, I hope you learned something new from this random post!
Musings of a Generic Asian 
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