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