FAQS Sex Change Surgery

Who is the candidate for sex change MTF surgery? 

A suitable candidate for sex change MTF surgery is a person who has been 

diagnosed with at least one of the following disorders: 

o gender identity disorder 

o gender dysphoria 

o associated conditions 

What are the requirements to have sex change MTF surgery? 

As our doctors follow Transgender sex change guidelines from “The Harry 

Benjamin International Gender Dysphoria Association” Standards of Care for 

Gender Identity Disorders, a patient must meet the following requirements 

before having the surgery: 

1.) Legal age of maturity age in the patient nation. 

2.) Psychology certificate stating that you are a suitable candidate for sex 

reassignment surgery by a psychiatrist or clinical psychologist who is a 

professionally qualified specialist in the field of gender dysphoria. 

3.) Hormone therapy certificate stating that you have been on hormone for at 

least 1 year. 

Where can I take hormone treatment? 

A patient should see an obstetrician-gynecologist to ask for a hormone 

prescription. Side effects can be bad if there is over dosage. It is not advisable 

to take hormone on your own since you should be monitored for side effects 

while taking it. 

Where can I get the psychology certificate? 

A patient of sex change surgery should see a psychiatrist or clinical 

psychologist who is a professionally qualified specialist in the field of gender 

Dysphoria. 

What are the effects of estrogen hormone? 

Genetic males treated with estrogen may expect the following results: breast 

growth, some fat redistribution to approximate a female body, decreased upper 

body strength, softening of skin, some decrease of body hair, slowing or 

stopping of scalp hair loss, decreased fertility and testicular size, less frequent 

and less firm erections. These changes are reversible, except for breast growth 

which may not regress after hormones are discontinued. 

How is the sexual life after the surgery? 

After sex change surgery, a patient can have normal sexual sensation. Sexual 

arousal is not only a physical sensation but it is also very much a 

psychological experience. It means that for you to have a fulfilling sexual 

experience, you have to be ready in both aspects. During removal of the penis 

and testicles, the skin, together with its nerve supply, are retained and used to 

line the new vagina. Also, a new clitoris will be formed from part of your 

glans penis (head of the penis) also with its nerve supply intact. Therefore, 

with this in mind, sexual sensation is still guaranteed. 

How long should I stay in Thailand for sex change surgery? 

In order for a patient to have sex change surgery, the patient should stay in 

Thailand at least 2-3 weeks to complete a whole process and allow the proper 

healing. On an arrival day in Thailand, a patient should stay in a hotel to relax 

from a long flight and have a surgery on the following day. Gender 

reassignment surgery from male to female will require a patient to stay in the 

hospital for Approximately 14 nights. 

How is surgery performed? 

The sex change surgery is safe and effective. It takes approximately 4-8 hours. 

The procedure begins with the surgeon creating the vaginal cavity between 

rectum and the urethra by cutting some of the pelvic floor muscles to insert the 

neo-vagina. The surgeon then makes an incision to open the penis. The urethra 

is shortened and re-routed to emerge lower, just above the new vaginal 

opening. After the vaginal cavity is created, the surgeon cuts the scrotal skin to 

removes the testicles. The scrotal skin including the surrounding tissue is then 

used to construct the external genitalia such as labia minora and labia majora 

to create a neo-vagina similar to the biological female genitalia. 

The surgeon uses the “Penile Inversion Vaginoplasty” technique which turns 

the penile skin inside out to line the vaginal wall. This technique limits the 

depth of the vagina depending on the amount of the penile skin available. In 

patients with short or small penis or who have had circumcision, the surgeon 

uses the scrotal skin graft in conjunction with the penile skin to increase the 

vaginal depth, usually 6-7 inches. The surgeon then constructs the clitoris by 

retaining a small section of the glans penis with its blood supply and nerves 

intact, since the nerves of the glans penis is analogous to the nerves of the 

clitoris in female. This is then positioned above the urethral meatus. At the 

same time the labia minora is created using part of glans penis and prepuce 

skin. 

What is the post-surgical care? 

After sex change surgery, the patient will be under the surgeon’s close 

supervision and he will inform you of everything you need to know. The 

following post-operative care guidelines should be observed: 

o The first 2-3 days the patient will be on a clear liquid diet and must 

avoid fibers and milky beverages that can induce defecation to avoid 

infection. 

o At bedtime, use the wrap to lie between legs while sleeping to prevent 

the wound being pressed. 

o Use a vaginal douche or sterile solution to clean the wound to prevent 

infection. 

o The patient will be able to walk after 5-7 days 

o Use a small size dilator and gradually increase in width and size, as 

you feel fit. You should dilate the neo-vagina 3-4 times a day. Dilation 

is needed everyday for 2-3 months then once a day after one year. 

o 2 weeks after surgery return for a follow-up check and removal of 

stitches. 

You should not engage in sexual intercourse until at least 2 months after the 

surgery. 

What are the possible risks and complications? 

The possible main risks are swelling, bruising, bleeding, infection, scarring 

and numbness, or change in sensation. Following the surgeon’s advice will 

reduce risks and complications.