Oneness Ministry

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Gender Surgery

Continuing from the previous blog post, doing research concerning transition and Genital Reassignment Surgery (GRS) is very important.  The older term SRS (Sexual Reassignment Surgery) is still used by some.  Please review this page in the Gender Learning Center (Click here) for assistance in your research.

SRS/GRS is not as complicated as one would think.  The procedure has been done now for over 50 years and lately the surgeons are getting very good at it.  Some of the issues to be concerned with are logistics, cost and convenience.  The skill of the surgeon is a very hot topic and while this is important, it is not as big an issue as it would seem.  Depending on where the surgery is done, most countries have strict standards doctors must abide by, especially since surgery and medical care has become a commodity that brings in big money.  Thailand and India are emerging as world leaders in this market so they definitely deserve a close look and your consideration when it comes to choosing your surgeon and location.   The price you pay is many hours in a plane traveling across the world to save a few thousand dollars.  When you can barely sit down, being in an airplane for 20+ hours is not appealing.  Of course there are options to cope with this such as meds and cushions.  From what I hear it is worth the trip.

The USA has several very good surgeons now doing SRS/GRS, so look closely at the local options.  Most gender therapists will know who they are as do the gender support groups.   I will not list them here because I would leave some out and that is not my purpose here.  The informational sites I list on my website do include several surgeons, however I chose them on the basis of information provided, not on how good the surgeon is.  If you have questions or need help finding someone close to you I am happy to assist.  See the website Unity in Gender Diversity.

Logistics includes things like travel, housing, post care, assistance during recovery, preparations before surgery, documentation (passport, proper ID, surgery letters from your therapist), and medical records.  Each surgeon will have requirements for you to meet, and they give ample advanced notice in most cases, however it is prudent to research this, so you are prepared.  Call it peace of mind.

Cost is an issue that we all are acutely aware of.  Many options exist however it is recommended that you get references from the surgeon you choose and make sure the location has the resources to provide safe and effect treatment in the event of an unexpected emergency.   The costs include, travel, housing, food, surgeon fees, hospital fees, operating room fees, anesthesia fees, and medicines.  Most surgeons have package deals so make sure exactly what you are getting and what will be extra.  The recovery time is at least two weeks and many take as much as six weeks, so another cost is time off of work.

Convenience is the last but not least concern when choosing a surgeon and location.  It is not to be under estimated. From the many post op transsexuals I have talked with, being able to travel a short distance to the surgery center and home again is a real plus.  The horror stories of being on a plane for hours and hours is something to consider carefully.  Take into consideration your age, possible side trips, who will be with you, and your travel experience.  Those who are seasoned travelers will be more inclined to go far to save a little money.  I also hear that sightseeing in places like Thailand can make it all worthwhile.  Don’t rule out locations such as Europe, Mexico, Caribbean, India, or Canada.  Check with your local Gender support group for those surgeons who are close to you and be sure to check credentials and review customer satisfaction of others who have experienced their services.

Sequoia Elisabeth

Unity in Gender Diversity     Discover Sex and Sexuality click here



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SRS/GRS Treatment Planning

Where does SRS/GRS fit into the treatment plan for Gender Incongruity(GI)/Gender Identity Disorder(GID)?  The terms GRS (Genital Reassignment Surgery) and GI (Gender Incongruity) will be used from here on to make this flow easier.  The diagnosis has been made and you are now in therapy, so what next?

The answer to this question is really up to you and your therapist or physician.  There are no rules here so I recommend doing your research and getting to know the options as well as getting to know yourself a little better. Your therapist should be helpful in guiding you in the decision of whether you need GRS and where to place it in your treatment plan.  It is not their decision to make though, it is yours.  Please understand that you are responsible for finding your way to relief.  The professionals are there to help and provide guidance.

The next step is to decide if you have enough funding to get the surgery soon or will it be years before you can afford it?  If you have money or the resources to get it, then you have several options.  Even if you don’t have the money now, you have options.  Here they are.  Get an orchiectomy right at the beginning (if you are FtoM – hysterectomy) so you do not have to take hormone blockers.  For FtoM it just makes the testosterone that much more effective.  Any cosmetic surgeries desired can be done later in the transition as is convenient.  After fully transitioning and living in the chosen gender and knowing you are happy, get the full GRS.  This option makes the most sense to me, however most doctors are uneasy with this choice, probably because they are not the ones with discomfort. (Reproduction desires need to be addressed also, since this option sterilizes)

The next option is to get hormone treatment and electrolysis done and after going full time as your chosen gender, have GRS done and leave cosmetic surgery to last.  The reasoning here is financial and basically goes in order of importance and cost.  This seems to be the most popular option chosen, for obvious reasons.  Start where you are and take a new step each day toward your ideal. 

Those with lots of money sometimes get carried away with the surgeries and do all kinds of physical alteration without fully embracing the changes emotionally.  From my experience this is a difficult path and somewhat backwards.  Gender transition is an emotional process and the surgery is meant to assist in the assimilation into society.  Where the surgery is very important, so is taking the time to learn what it means to be a woman when you were raised as a man, or vice versa.  Jumping in with the surgery can lead to disaster when you have changed your appearance and not your self concept. 

When I first started my journey one of the questions I asked my therapist is where does GRS fit into my treatment? (I already knew I wanted it, and most of us do)  He told me it does not matter if you get it early or later, the important part is to break down the false persona you created to fit into society and allow your natural self to emerge.  The surgery will re-enforce your feelings and make it easier for you, but does not really matter to a person who will never see between your legs!  GRS is for your own satisfaction in knowing your body reflects your self image.   

🙂 Sequoia Elisabeth

Unity in Gender Diversity     Discover Sex and Sexuality click here

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Is SRS Really Necessary?

This is first in a series of blogs on Sex Change Surgery, so the obvious question “Is SRS/GRS Really Necessary?”  Right from the start I will concede this is a loaded question; however, it is a question I have asked myself many times.  The answer is as individual as the person considering it.  The answer should NOT be undertaken alone and should be a consensus by medical professionals trained in gender issues and the transsexual individual.  The bottom line is no one can tell you what your gender is!  Gender is self determined, however the treatment for Gender Incongruity or Gender Dysphoria as it used to be called is a complex issue that requires guidance.  I am not saying it could not be done alone, only that is much easier and more rewarding when support is provided by caring professionals, friends, and family.

With this being said, it would be foolish to jump to a conclusion when something as drastic as SRS (Sex Reassignment Surgery) or as some prefer, GRS (Genital Reassignment Surgery) is considered.  The question of other conditions being present such as mental illness, birth defects, medical conditions etc. needs to be ruled out before surgery is implemented.  Just as a doctor considering a liver transplant will make sure the patient does not have any other severe conditions which may hamper recovery from the surgery; it is only prudent to take an informed approach.  Thus we have the WPATH Standards of Care which recommend a thorough medical work up, Psychotherapy evaluation, CHT (Contra Hormone Therapy), and living at least a year in the chosen gender to avoid the possibility of erroneous Gender Incongruity diagnosis. 

The treatment for Gender Incongruity (GI) or GID (Gender Identity Disorder, as it used to be called) is the surgical adjustment of the genitals to conform to the gender identity of the individual.  Counseling and/or psychotherapy is part of both the diagnosis and the treatment.  Dealing with an issue this large should not be undertaken alone.  At the very least a person with gender questions should see a professional that specializes in the treatment of gender disorders.  There are resources online that will help to identify those professionals, please see this link (take your time and read carefully). 

Getting back to the issue of “is it necessary” I offer another link to a blog that considers this issue nicely.  Having been on this journey for a long time, I will share my personal experience on this question after having talked to many pre and post op transsexuals.  I only know of a few cases of post op transsexuals who were not happy with the surgery.  Three of those were media hyped cases of individuals who were mislead by society.  Personally I have known only one person (a pre-op transgender) that transitioned with hormones for 10 yrs and then decided to de-transition and live in their former role. 

On the other side of the coin I have met dozens of post op transsexuals who tell me it was the best decision they ever made.  They lead happy productive lives just as they did before they transitioned.  The variation in the success of SRS/GRS is as varied as the individuals undergoing the procedure, however it is my firm belief that if this option was not the best choice then there would not be so many surgeons doing the procedure today and it would not be considered medically necessary as it is by the AMA, IRS and some Insurance Companies today (see above links).  It is true that not many Insurance companies will cover SRS/GRS, but their numbers are growing as is the mainstream medical communities support for this treatment of Gender Incongruency. 

Choosing to undergo SRS/GRS is not something anyone should take lightly, however it is a viable option nowadays that offers excellent results of both form and function!  It is time the rest of the medical community step up and see that Gender Incongruity is a serious issue that has viable treatment options with excellent results.

🙂 Sequoia Elisabeth

Unity in Gender Diversity     Discover Sex and Sexuality click here

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