Sex Change SRS Female to Male Thailand

Female to male gender reassignment sex change surgery is the last solution to treat “Gender Identity Disorder” to create analogous male genitalia to conform to the patient’s deepest feelingof self-being in gender identity. FTM gender reassignment sex change surgery is a surgicalprocedure with a history of decades, and is in progressive development through continuous medical studies, medical research and advanced technology in surgical
technique. The present achievement in sex change is more successful than before with high quality of standard care and treatment just like male to female gender reassignment surgery, only it is more complicated and lengthy, the procedure takes about one to two years tocomplete.

Three stages for Female to male (FTM) gender reassignment :             

Stage 1.1  Subcutaneous Mastectomy (Breast reduction)
2 nights stay in the hospital

Stage 1.2  Hysterectomy (Removal of uterus & ovaries)
4 nights stay in the hospital

Stage 2.1  Vaginal closure & urethral lengthening
                 
Stage 2.2  Urethral prefabrication                                            
7 days stay in the hospital for stage 2

Stage 3     Male genital organ construction (phalloplasty)      14 nights stay in the hospital

Optional  

- Penile implant with groin (excl. cost of prostheses)
3 nights stay in the hospital

- Penile prosthesis     

Hospitalization:
Stage 1: 6 nights
Stage 2: 7 nights
Stage 3: 14 nights

Follow up:1 week after discharge from the hospital for all procedures.

Length of stay in Thailand:
Stage 1:           2 weeks
Stage 2:           2 weeks
Stage 3:           1 month                                      

In order to be a candidate for sex change surgery you must meet the requirementsbelow:

1. Provide a certificate from a licensed psychologist stating that you are a suitable candidate for sex change surgery.

2. Provide a medical certificate stating that you are healthy and fit to undergo surgery.

3. Provide documentation (prescriptions or other documentation) that you have been taking hormones for at least 1 year.

Individuals suffering from gender identity disorder are candidates for gender reassignment surgery. If you are a female, who has lived your life as male for several years, then you are a likely to be a good candidate for a female to male gender reassignment surgery. We follow Harry Benjamin GID requirements: a letter of recommendation from your psychiatrist is required, you should be HIV negative. You should quit smoking for life. Furthermore, you should stop taking hormones, aspirin, vitamin E, and should inform of any medication you are currently taking 2 weeks prior to surgery. You should also have been $taking male hormones for at least one year.

After you have passed a psychological evaluation, you should also need to make the following preparations:

The treatment process for FTM gender reassignment surgery

Stage one

This surgery is the reduction of breast volume to provide the patient with masculine breast features. A semi circular U-shape incision located at the junction of the normal skin and areola skin is made.  The incision leaves minimal scarring, easily hidden upon recovery, as the skin pigment will blend with the color of the areola. The procedure is approximately 2 hours, after the surgery the surgeon will place a tube for two days to drain the blood and prevent accumulation.  Stitches will be removed after 1-2 weeks.

Males do not have uterus and ovaries therefore it is very important that uterus and ovaries are removed for this group of patients so that they do not face the problem with menstruation and on the other hand eliminate the hormone producing organ. This is done by a gynecologist and can be done together with Subcutaneous Mastectomy. After the first and second procedure, when the wound in the breast as well as the internal and external abdominal wound is totally healed after approximately three months, there will be a follow-up check with the surgeon to evaluate the condition of the wound and tissue to prepare for the second stage procedures.


Stage two

This is the step wherein the path of the urinary tract is altered and the vaginal closed. It is because the direction of the female urinary tract is facing downward while the male urinary tract is in front. Therefore the surgeon is required to alter the direction of the urinary tract and completely close the vagina. The length of the urethra is also made longer and prepared to join with the urethra at the forearm in the last step. The surgeon will lop off the wall of the vagina and fold it back outward (vaginal mucosa reflection) and lop off the tissues in the vagina and to closed it completely. When this procedure is completed the patient will not have a vaginal opening and the patient can urinate at the front direction, like that of a male but without the penis yet. The healing process take about 2-3 weeks: the patient is required to stay in the hospital for 2 days.  A catheter will be inserted for about 7-10 days: it will be removed after the urinary tract is healed.

Urethral prefabrication is the preparation of the urethra to a penis (using the forearm flap Phalloplasty). In creating the penis at Yanhee International Hospital, the surgeon uses the forearm fascia; skin, nerves and blood vessels are raised and transplanted by microsurgical technique. To reduce the percentage of urine leakage the surgeon will create a urethra by wrapping the catheter with glutei skin and bury into the forearm.  After the grafted skin is healed, the result is a sturdy urethral tube, and when used to create the penis, percentage of urine leakage is minimal. The surgery is only one hour and the patient is required to stay in the hospital for 2 days.  After the surgery, the patient will have a catheter in the forearm and will be on a regular check-up by the surgeon along with self-care procedures for 3 months until the urethra constructed in the forearm is ready the next stage.

Stage three
The last stage involves construction of the male genital organ. When the patient has reached this stage, external physical features of the patient are almost those of a male; flat chest, no ovaries, no uterus, able to void at standing position but without the male organ to control the direction and flow of urine. Hence, the surgeon will create the male organ by transferring the forearm flap and join the structures through microsurgical technique. 4-6 inches penis, depending on the length of the patient’s forearm can be obtained.  On average, penis length is about five inches. The surgeon separates the blood vessels and nerves of the forearm to connect with the blood vessels and nerves in the pubic area then creates a scrotal sac from the tissues of the labia. This scrotal sac consists of fat and pigmented skin of the labia, but without testicles inside. External appearance is similar to the male scrotal sac. All patients that complete these stages have a successfully reconstructed penis and all the physical changes from female to male without any residual female sex organs. No serious complications such as flap failure, infection, serious wound complications and urination leakage has been found.  Patients all recover from the surgery fast because each stage consumes short time period without the need to correct the serious complication. All of the patients can urinate through the end of the neo-penis and the external appearance is similar to that of the genetic male sexual organ and also sensate.