Sex reassignment therapy (SRT), also called gender reassignment, is a term used to describe many different things, including sex reassignment surgery to modify primary sex characteristics, hormone replacement therapy to alter secondary sex characteristics, and other procedures to alter appearance.
Reasons to Undergo SRT
Individuals who choose sex reassignment might decide on this for a variety of reasons. Some people are born with ambiguous genitalia, which means that they have internal and/or external sex organs that display characteristics of both male and female sex organs. When this happens, individuals are usually assigned a sex shortly after birth, but may decide later in life that it's not right for them.
Gender identity disorder (GID) is a condition that causes you to develop a strong personal identification with the opposite sex. This does not have to do with your sexual identity, as you may be heterosexual, homosexual, or bisexual—but instead with the presentation of your own gender.
For any of these reasons (or others), an individual might elect to begin the transitioning process. This usually begins with assembling a team of experts, including mental health professionals, endocrinologists, and surgeons.
Preparing for SRT
Psychotherapy is usually the first step in gender transitioning. This includes working with the individual to make sure that they are realistic about the process of reassignment and understand the permanent ramifications of undergoing surgery. Also, the therapist will guide the individual through the next step of the process: real-life experience.
The World Professional Association for Transgender Health requires that transgender people live as their desired gender before they are able to pursue any permanent transitions. This includes beginning the legal name-changing process and being referred to by the appropriate pronouns by others. They also must maintain employment, attend school, and continue any other activities that are consistent with their daily life. This is to ensure that the individual witnesses the reactions of others and is still completely sure of their transition.
Medical Aspects of SRT
After three months of real-life experience, the next logical step is beginning hormone therapy under the guidance of an endocrinologist. This is a way to help individuals feel more comfortable in their desired sex. Male-to-female candidates will begin taking testosterone-blocking agents along with female hormones such as estrogen and progesterone. This will cause breast growth, softer skin, less body hair, and fewer erections. Female-to-male candidates will start taking testosterone supplements, which will deepen the voice and may cause hair loss or baldness, as well as shrinkage of the breasts, and an increase in sex drive. Two years of hormone therapy are usually necessary to see the full results.
If the individual wishes to continue transitioning after this point, surgical options will be discussed. Before surgical options will be considered, the individual must complete at least one year of real-life experience and hormone therapy, as well as produce at least two letters of approval by therapists and physicians. These surgeries are also quite expensive and are usually not covered by insurance policies, so it may take some time to save up the money.
Possible surgeries for male-to-female gender reassignment might include breast augmentation, orchiestomy (removal of testicles), penectomy (removal of penis), vaginoplasty (creation of vagina), clitoroplasty (creation of clitoris), and labioplasty (creation of labia). Surgeries for female-to-male transitioning are less common, since they are generally more complicated and less successful. They can include a mastectomy (removal of breasts), a hysterectomy (removal of uterus), salpingo-oophorectomy (removal of fallopian tubes and ovaries), and a metoidioplasty/phalloplasty (construction of penis).