What Is Gender Affirmation Surgery?

Gender affirmation surgery helps people transition to their self-identified gender. This surgical treatment may include facial, top, or bottom surgery. People may choose to undergo this operation due to gender dysphoria.


Overview of Gender Affirmation Surgeries


These surgeries are not necessary for all transgender and nonbinary individuals. Yet, many people undergo one or more procedures. They do so to achieve their desired gender presentation. It is best to consult a cosmetic surgeon to discuss various options.


Penile and Vaginal Construction


Penile construction surgeries, including metoidioplasty and phalloplasty, involve the following processes:

  • Removal of the vagina

  • Reconstruction of the urethra

  • Penile reconstruction

Surgeons may use vaginal tissue or tissue from another body part to construct the penis. Vaginal construction or vaginoplasty is a multistage process that involves several processes. The cosmetic surgeon removes the penis and testes. Next, he/she uses the penis tissue to construct the vagina, clitoris, and labia.


Top Surgery


Top surgery augments remove breast tissue and reshape the chest. This helps create a feminine or masculine appearance for nonbinary and transgender individuals.


Facial Gender Surgery


Facial gender surgery can achieve more male or female facial features. The procedure to create feminine features may include the following:

  • Reshaping the nose

  • Lip augmentation

  • Hairline restoration

  • Brow lift

  • Chin, cheek, and jaw reshaping

  • Earlobe reduction

  • Adam’s apple reduction

For more masculine features, it may include forehead lengthening and cheek augmentation. The surgeon will also reshape the nose, chin, and jaw. A thyroid cartilage improvement will help construct Adam’s apple. Hormone replacement therapy can help achieve these changes to the face. Yet, surgery may help in getting the desired results.


Hysterectomy and Orchiectomy Surgeries


The former is the surgical removal of the uterus and ovaries. The latter is the surgical extraction of one or both testicles. Bilateral orchiectomy involves removing both testicles.

This procedure reduces testosterone production. Thus, patients do not need to continue therapy with androgen-suppressing medications and estrogen. Your healthcare provider may discuss several options. These include sperm freezing before orchiectomy. That can preserve your ability to become a biological parent.


Preparation for Gender Affirmation Surgery


It is best to consult a healthcare provider to understand the risks and benefits. Insurance companies may also need specific documentation to cover gender-affirming surgeries.


Procedure and Recovery


Procedures vary depending on the surgery chosen. How long it takes to recover will depend on the type of surgery performed. Swelling and soreness are common after surgery, and patients need follow-up appointments.




Gender affirmation surgery provides long-term mental health benefits. Like other surgeries, there are risks, but are rare when performed by an experienced surgeon.


When to See a Healthcare Provider


After surgery, patients should see their healthcare provider if they experience complications. These include prolonged bleeding or persistent pain.




These surgeries can help nonbinary and transgender individuals to transition gender. It is best to consult an experienced cosmetic surgeon. This will help you decide which surgical options suit you.

For more on gender affirmation surgery, visit Aron Kressel, MD, at our New York, NY, office. Call 212-772-6968 to schedule an appointment today.

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