Gender Confirmation Surgery (GCS)

What is Gender Confirmation Surgery?

Before Anesthesia is Given.

Gender confirmation surgery (GCS), known clinically as genitoplasty procedures, surgically alter the genitalia. For most patients, GCS is performed to further confirm their genders by aligning it with their desired physical sex characteristics.

Gender dysphoria, or experiencing of a lack of alignment between gender and sex, is becoming more widely diagnosed. People diagnosed with gender dysphoria are often referred to as "transgender," though one does not necessarily need to experience gender dysphoria to be a member of the transgender community. It is important to note there is controversy around the gender dysphoria diagnosis. Many disapprove of it, noting the diagnosis suggests being transgender is an illness.

Gender confirmation surgeries are also called gender affirmation procedures. These are both respectful terms. Although sex and gender differ, these surgeries are referred to as gender confirmation surgeries (GCS) because they are undergone by trans people to align their sex based characteristics with their gender.

Transfeminine Transition

Transfeminine is an umbrella term inclusive of trans women and non-binary trans people assigned male at birth.

The procedures that change genitalia typically associated with this group include a penectomy (removal of external genitalia) and orchiectomy (removal of the testes), which are typically followed by a vaginoplasty (creation of the vagina) or a feminizing genitoplasty (further creation of internal genitalia).

For those transitioning further, there may also be procedures that include breast implants, gluteoplasty to increase buttock volume, a procedure to minimize the appearance of the Adam's apple, and possibly, feminizing hormones.

Facial feminization surgery (FFS) is often done to soften the lines of the face. Each patient is unique and the procedures that are done are based on the individual's need and budget, but facial feminization often includes softening the brow line, rhinoplasty (nose job), smoothing the jaw and forehead, and altering the cheekbones.

For some, a chondrolaryngoplasty, commonly known as a "tracheal shave," can help reduce the prominence of the Adam's apple.

Transmasculine Transition

Transmasculine is an umbrella term inclusive of trans men and non-binary trans people assigned female at birth.

The procedure that changes genitalia for this group is a masculinizing genitoplasty (creation of external genitalia). This procedure uses the tissue of the labia to create a penis. Procedures that change the genitalia are rarely performed without other procedures, which may be extensive.

For those in this demographic who transition further, the change to a masculine appearance may also include hormone therapy with testosterone, a mastectomy, a hysterectomy procedure, and perhaps additional cosmetic procedures intended to masculinize the appearance.

Paying For Gender Confirmation Surgery

While some health insurance providers in the United States are now covering a portion of gender confirmation surgery, those companies remain in the minority.

For most transgender individuals, the burden of financing the procedure(s) is the main difficulty in obtaining treatment. The cost of transitioning can often exceed $100,000 in the United States, depending upon the procedures needed.

A typical genitoplasty alone averages about $18,000. Rhinoplasty, or a nose job, averaged $5,409 in 2019.

Traveling Abroad for GCS

Some patients seek gender confirmation surgery overseas as the procedures are often far less expensive in other countries. It is important to remember that traveling to a foreign country for surgery, also known as surgery tourism, can be very risky.

Regardless of where the surgery will be performed, it is essential to utilize a surgeon who is skilled in the procedure being performed and that surgery will be performed in a reputable facility that offers high-quality care.

Choosing a Surgeon

When choosing a surgeon, it is important to do your research, whether the surgery is performed in the U.S. or elsewhere. Talk to people who have already had the procedure and ask about their experience and their surgeon.

Before and after photos don't tell the whole story, and can easily be altered, so consider asking for a patient reference with whom you can speak.

It is important to remember that surgeons have specialties and to stick with your surgeon's specialty. For example, you may choose to have one surgeon perform a genitoplasty, but another to perform facial surgeries. This may result in more expenses, but the right surgeon performing the right procedure typically results in a better outcome.

A Word From Verywell

Gender confirmation surgery is very complex, and the procedures that will be necessary for one person to achieve their desired result can be very different from what a different patient will require. Each individual's goals for their appearance will be different, and the surgical needs of the patient will vary as well.

A personalized approach is essential to satisfaction because personal appearance is so highly individualized. For example, one individual may feel strongly that breast implants are essential to having a desirable and feminine appearance, while a different person may not feel that breast size is a concern.

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Article Sources
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  5. American Society of Plastic Surgeons. Rhinoplasty nose surgery.

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