Sex Reassignment Surgery (Female To Male) in Nepal

Anesthesia is given to ensure that the patient does not suffer from pain during the surgery. Top and bottom surgeries are performed differently.

• Mastectomy: It is performed in two ways. In one method, an incision is given around the areola and excessive fat and breast tissue are removed through it. The skin is left as it is for a year. It retracts in this period of time. This method leaves prominent scars. In the other method, excess skin is also removed along with the tissue and fat. This leaves fewer scars. After this, male-like the contour of the chest is obtained.

In the other step, female reproductive organs that are present inside your body are removed.  

• Hysterectomy:  Total Hysterectomy is the removal of uterus and cervix. Another surgery, bilateral salpingo-oophorectomy (BSO) is performed to remove fallopian tubes. In this way, the entire female reproductive system is eliminated from the body.

After this, procedures for the construction of male reproductive organs begin. They include,

• Metoidioplasty: Androgenic hormones are given to increase the length of the clitoris. Length is increased to almost 1.6 to 2 inches.
• Phalloplasty: It is performed to create a penis or to increase the length of it. It can be done in 4 ways. All of these work on the same principle. A flap of skin is taken from a donor site of the body such as an arm or abdomen to make a penis out if it. It is joined to the urethra. This is the most complicated step of GRS. An erectile prosthesis is inserted into the penis to achieve an erection.  
• Scrotoplasty: Scrotum is produced from labia majora and prosthetic testes are inserted into it.  

It is a long procedure involving a number of surgeries. There is top surgery and bottom surgery. Mastectomy takes 2 to 3 hours in the operation theatre. While bottom surgery requires more time. It takes 8 to 10 hours for a female to male GRS. You should plan to stay in the area for at least 14 days after your Procedure, During this duration, your health conditions are monitored regularly and your stitches are removed after 10 to 14 days. You can go home when allowed to by your physician.

You will have to take 2 weeks off work. After 2 weeks, you can start a light activity and can go back to office work. A Patient will need more time to get back to physical work. You can start strenuous activity 4 to 6 weeks after bottom surgery. Pain killers are given in this period to deal with moderate pain. Scars take some time to fade away. It can take years after the surgery to settle both physically and psychologically.

Following points should be considered to look after you post-surgery:

• Go for regular check-ups.
• Take your medicines as and when prescribed by the doctor.
• Live with someone who takes care of you while you recover.  
• Abstain from sexual activity till allowed by your doctor.
• Do not take a bath or shower with bandages intact. It can cause infection.
• Avoid strenuous exercise in the early few days after surgery.
• Do not lift heavy objects; it puts pressure on your stitches.
• Avoid excessive movement. Take a rest.

The success rate of Sex Reassignment Surgery (Female To Male) within Nepal depends on a spectrum of elements. Such factors encompass the proficiency and prior expertise of the surgical unit, the comprehensive health condition of the person, their mental readiness, and compliance with the suggested after-treatment attention. An abundance of research has pointed out that a majority of individuals who choose Sex Reassignment Surgery (Female To Male) acknowledge a marked enhancement in their lifestyle quality, elevated mental health, and a noteworthy contentment level with the physical transformations.

According to a study, 97% of the people who went through this surgery found their results satisfactory. You need to be sure before opting for it, as it is a lifetime decision. GRS is mainly for the treatment of dysphoric and transgender people.

The following are some alternatives to sex reassignment surgery:

• Hormone replacement therapy: this therapy aids in changing your secondary sex characteristics according to your desired sex. In the case of female to male sex change, testosterone is given. This induces hair growth and coarseness of voice. It reduces breast growth and changes in fat distribution in your body. It also stops menstruation.
• Altering physical appearance: you can alter your physical appearance, your dressing, your hair, your makeup in accordance with your desired sex. Do regular exercises to build up muscle mass which will make you look like a male.
• Psychological counseling: it will make you handle your personality. Gender reassignment surgery cannot be reversed. Therefore, you should make your decision wisely.
• Cosmetic surgery: it is a wide field covering a number of domains. It can alter your facial features, your body fat, your waist, your stomach, your chest to transform you into your desired gender. You can go for liposuction, mastectomy, Botox, fillers, Rhinoplasty, etc.

All of the methods, mentioned above are not permanent but are helpful. For permanent change, you have to go for sex reassignment surgery.