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We're starting the process with Ting, who wants a vagina. The network of moms is supportive. Nicole is a junior in high school, planning surgery between junior and senior year. She's doing great.

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If someone desires female anatomy but does not have it, there is a surgical option available. This procedure involves inverting the penis to create a vagina.

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"Speaker 0: A phalloplasty is a procedure to basically create a penis or a phallus for an individual who was born biological female and who seeks transition to, a male, gender." "Speaker 0: The procedure is done with plastic surgeons and urologists." "Speaker 0: The urologists manipulate the tissues in the surrounding area to lengthen the urethra." "Speaker 0: A new scrotum is created and, some of the anatomical parts of, the female anatomy are removed." "Speaker 0: We typically utilize tissue from elsewhere." "Speaker 0: For example, the forearm or the thigh is used." "Speaker 0: The plastic surgeons are also responsible for, providing sensation by doing the nerve coaptation so that the new phallus will have sensation, and also responsible for reestablishing the blood supply, and also to shape it in a way that appears more physiologically and anatomically like a natural one."

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Chest reconstruction is a procedure that we perform to patients who identify as non binary or transmasculine or interested in, having their breast removed and to reconstruct a more masculine appearance of their chest. Most of the times it includes a mastectomy, which is the medical term to describe a removal of the breast tissue, but also, building a more masculine appearance to the chest, eliminating the inframammary fold and reconstructing the nipples in a more masculine position and appearance.

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A politician introduces a video clip of a surgeon who identifies as the "queer surgeon" and performs gender affirming surgeries. The politician expresses concern over experimental and irreversible procedures being performed on children. In the clip, the surgeon states that 80% of their practice is gender affirming surgery, with a focus on genital surgeries like vaginoplasty and phalloplasty. They acknowledge an increase in adolescents seeking surgical intervention, which presents unique challenges, especially for those who have undergone puberty suppression. The surgeon admits that there is a lack of published research on genital surgeries for pubertally suppressed adolescents and that they are "just kind of learning and figuring out what works." They explain that puberty suppression affects the amount of tissue available for vaginoplasty, requiring alternative techniques like using peritoneum to line the vaginal canal. The surgeon notes that they will know more about the outcomes in 5-10 years and that it will be fascinating to see how these kids turn out. The politician then condemns these procedures as "barbarism" and "mutilation of children" that should be illegal. They claim that children lack the capacity to make such life-altering decisions and that sex is an immutable characteristic.

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If you want to reduce exposure to estrogenic and endocrine-disrupting chemicals, especially to boost testosterone levels naturally, get rid of the chemical strip at the top of your razor. The speaker does not specify what chemicals are in the strip due to potential censorship. Research the ingredients and consider that these chemicals may enter your skin when shaving. These chemicals are found in sunscreen, hair gel, toothpaste, lotions, and deodorants. The skin is the largest organ and absorbs what you put on it, so detoxification requires considering skincare products.

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I was recently diagnosed with vaginal stenosis after my bottom surgery eight months ago. This condition causes scar tissue to build up in the vaginal canal, making it extremely tight and uncomfortable. For the first year post-surgery, regular dilation is necessary, but now I can't dilate due to the stenosis. Although my vagina has depth, it's at risk of closing and causing infections, which means I need another surgery to fix it. Despite the challenges, I don't regret my transition; it has brought me happiness and comfort in my body. I want to be open about my struggles as a transgender person. Bottom surgery is tough, but I believe it will be worth it in the end. I'll keep everyone updated on my surgery schedule.

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The speaker recommends using sodium bicarbonate for hair, body, and clothes. They warn against Sodium Lauryl Sulfate in shampoos, which can harm hair follicles. They suggest looking for natural shampoos without this ingredient at stores like Trader Joe's or Whole Foods. The speaker personally uses coconut oil on their hair every 3 months and uses a coconut oil-based shampoo for nourishment.

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Penile inversion vaginoplasty is the full name of vaginoplasty. In this procedure, the surgical team is creating the outer and the inner vagina. The reason it's called penile inversion vaginoplasty because we use the penile skin and the scrotal skin in order to reconstruct the vagina. By doing so, we break it down to all of its components and we use some of the tissue to reconstruct things the way they were supposed to be for that patient.

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There is not one surgery that every transgender person wants. Many transgender people have no interest in having surgery. For other people, they undergo medical transition involving use of gender affirming hormone treatments. And for others, they may have one or more surgeries. They may have top surgery, which is surgery on the chest or breasts. They may have bottom surgery, surgery on the genitals. They may have facial feminization. Trans women may have a tracheal shave to reduce their Adam's apple. No two trans people have the same needs to resolve their gender dysphoria. So you can never make an assumption that any trans person wants any particular surgery or any surgery at all.

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A gender affirming hysterectomy is very similar to most hysterectomies that occur. Hysterectomy itself is the removal of the uterus, the cervix, which is the opening of the uterus, and the fallopian tubes, which are attached to the sides of the uterus. Some gender affirming hysterectomies will also include the removal of the ovaries, but that's technically a separate procedure called a bilateral oophorectomy. And not every gender affirming hysterectomy includes that, and people who are getting gender affirming hysterectomies do not have to have their ovaries removed.

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During the first bottom-surgery visit at Boston Children’s Hospital, the nurse introduces the team and sets expectations that you’ll meet many people and should not feel overwhelmed or try to remember everyone. The team’s goal is to provide information and answer questions. A social worker and physician's assistant review your medical and behavioral history and your goals for surgery to determine the best bottom-surgery option for you. Then Doctor Ganor and the nurse will wrap up the consult, cover the details of the surgery, post-operative expectations, needed support, how long you’ll be here, and review your questions. If you don’t have questions, staff provide information proactively. If you forget, you can call or email the team the next day; they’re accessible to help navigate the process because it can be a lot.

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"The eligibility for getting gender affirming surgeries at Boston Children's Hospital is basically the same as it would be for most other hospitals or surgeons in The United States." "And that's the case because we all follow the World Professional Association for Transgender Health or WPATH standards of care." "For top surgery, you are requested, but not required to have been on gender affirming hormones for at least a year." "If you're a trans woman, it's really encouraged that you be on estrogen for at least a year because you want to maximize your natural breast growth." "Many surgical centers require you to be 18." "At Boston Children's Hospital for top surgeries, we'll see people as young as age 15 if they've been affirmed in their gender for a long period of time and don't really have any other life complications that make surgery inappropriate."

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"Hi, I'm Maria. I use pronouns she, her, hers, and you're gonna meet a lot of folks, and don't be overwhelmed." "It's very much a two way conversation." "After that, Doctor. Ghanour and myself will come in to wrap up the consult, go over surgery in detail." "At that time, we'll ask you to change to do an exam that's very quick, have you change back into your normal clothes to then sit down and discuss everything with or without your parents, depending on your age and what your family desires." "We tell you to write down all your questions, to email anytime, to call anytime." "It can be very overwhelming and we give you a lot of information, but that first visit is mostly informational with one exam."

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Gender affirming hysterectomy is similar to a regular hysterectomy, involving the removal of the uterus, cervix, and fallopian tubes. Sometimes, the ovaries are also removed in a separate procedure called bilateral oophorectomy, but this is not always necessary for gender affirming hysterectomies. People undergoing this surgery do not have to have their ovaries removed.

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Penile inversion vaginoplasty, also known as vaginoplasty, involves creating both the outer and inner vagina using penile and scrotal skin. This procedure reconstructs the vagina by utilizing the patient's own tissue.

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This boy just had top surgery, and I want to share our journey. After the surgery, I was called to the Recovery Room. The surgeon was working on him, and there was a lot of blood coming from his scars. They informed me that they needed to take him back for more surgery because a blood vessel had popped. Unfortunately, we lost his right armpit hair during the process, but the left one remained untouched.

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A breakthrough in surgery is the ability to harvest the peritoneal lining. Jazz, a medical case, presents a challenge as her puberty was effectively blocked, preventing normal genital growth. This makes it difficult for surgeons to use a conventional approach. They are using the peritoneum tissue to create what can be described as a patchwork or Franken vagina.

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- "Vaginoplasty is a relatively big procedure." - "It takes about between four to six hours in the Operating Room and therefore there is some swelling involved, there's some pain involved." - "But most of the times we actually administer epidural anesthesia as well, which helps a lot with the pain management for the patient." - "A very big component of the vaginoplasty procedure is the post op care." - "Seven to ten days after the procedure, the patient is required to start doing dilations." - "In the dilations, they are using different sizes of dilators gradually, and they need to do that several times a day for minutes a day." - "The reason for that is because otherwise the cavity will not be maintained and the old reconstruction can be lost."

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Breast augmentation for transfeminine patients is augmenting or increasing the volume of the breast tissue. And when we do that, we're trying to reconstruct a more feminine appearance to the chest. We typically do that with silicone implants that can either sit under the muscle or under the breast tissue itself. To the majority of the patients, they have this surgery several years after being on estrogen because estrogen itself can cause a building of breast tissue. It's very typical that we will need to increase the distance between the nipple to the fold underneath the breast and we are able to do that in the same procedure as well.

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Facial hair growth varies from person to person, and genetics plays a huge role, though hormonal imbalances can contribute. For example, PCOS or polycystic ovarian syndrome is a very common hormonal disorder leading to increased androgens, which in turn leads to increased facial growth, particularly in like a male pattern. Treating the underlying cause is important. One medication used is brinolactone, an oral drug that helps block the androgens causing the imbalance. A second option is an oral birth control pill to regulate hormones and reduce excess facial hair. A third option is Vanica or L Florinetine Cream, which slows hair growth but requires ongoing use. For removal, shaving, waxing, threading, and laser hair removal are options; keep in mind laser hair removal is not permanent. It's permanent laser hair reduction, especially if hormones change over time. It’s normal; most women have facial hair. I personally have struggled with this.

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Karen Selva, pediatric endocrinologist and medical director of Randall Children's Hospital T Clinic, discusses puberty blockers for transgender and gender expansive youth. Puberty blockers work at the level of the pituitary gland and they actually suppress the release of the LH and the FSH so that the sex organs are no longer stimulated; The signs are blocked and don't progress. The main benefit is that they prevent the unwanted permanent effects of puberty, and thus future surgeries can be avoided as an adult. We can prevent chest reconstruction in affirm trans males or facial feminization surgery in transfemales. They are reversible; if stopped, endogenous puberty resumes. They can alleviate depression or worsening gender dysphoria. The Pediatric Endocrine Society recommends puberty suppression in clinical guidelines for transgender and gender diverse youth. The practice is new; first guidelines were published in 02/2009, and long-term data are not yet available.

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To maintain the size of your gauge after bottom surgery, you need to regularly use and stretch it like a muscle. If you don't, it may shrink over time. Even years later, it's important to give it a "tune up" if you're not using it often. Using a smaller size regularly can also cause it to shrink. It's not necessary to use it every day, but occasional use is like maintaining a car. If you don't use it, it may close up. Just like a muscle, it needs to be kept active.

The Peter Attia Drive Podcast

#43–Alan Bauman, M.D.: The science of male and female hair restoration—how to protect & restore hair

Guests: Alan Bauman

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In this episode of The Drive, host Peter Attia discusses hair restoration with Dr. Alan Bauman, a board-certified hair transplant surgeon. Attia emphasizes his commitment to providing trustworthy, ad-free content, funded by listener support, to share valuable health and longevity information. Dr. Bauman shares insights from his extensive experience, having treated over 20,000 patients and performed more than 8,000 hair transplants. He explains that hair loss affects nearly 100 million Americans, with about 80 million men and 46 million women experiencing some form of hair thinning. The conversation highlights the emotional impact of hair loss, particularly for women, who often face societal pressures regarding their appearance. The discussion covers various non-surgical and surgical hair restoration options. Bauman details non-invasive treatments like PRP (platelet-rich plasma) therapy, which utilizes the patient's own blood to stimulate hair growth, and low-level laser therapy, which enhances follicle function. He notes that while PRP can improve hair density, it is not a solution for completely bald areas. Attia and Bauman delve into the mechanics of hair transplantation, explaining the difference between traditional strip harvesting and follicular unit extraction (FUE). FUE involves removing individual hair follicles with minimal scarring, allowing for a more natural appearance. Bauman emphasizes the importance of donor dominance, where hair follicles taken from the back and sides of the scalp retain their characteristics even when transplanted to balding areas. The episode also addresses the psychological aspects of hair loss treatment, emphasizing the need for clear communication between the surgeon and the patient regarding realistic expectations. Bauman highlights the importance of a comprehensive approach that includes both surgical and non-surgical options to achieve the best results. Attia expresses his appreciation for Bauman's expertise and the advancements in hair restoration techniques over the years. The conversation concludes with a call for listeners to engage with the podcast and share their questions about health and longevity topics.

The Megyn Kelly Show

How Corporate Media Protects Biden, and Secrets to Younger Skin, with Sage Steele & Dr. Anthony Youn

Guests: Sage Steele, Dr. Anthony Youn

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Megyn Kelly opens the show discussing her experience watching the recent eclipse with her family, expressing a desire to travel to the path of totality next time. She then introduces Sage Steele, a former ESPN host who faced backlash for her views on the vaccine and race, leading to her departure from the network. Steele shares her experience of being scripted by ESPN for an interview with President Biden, revealing that she was not allowed to ask follow-up questions. This revelation sparked significant fallout, including criticism from former ESPN anchor Keith Olbermann. Steele discusses her new podcast, The Sage Steele Show, emphasizing her desire to engage in open conversations without being pigeonholed into a partisan narrative. She expresses gratitude for the opportunity to produce her own content and engage with diverse guests. The conversation shifts to the control exerted by mainstream media, particularly during the election cycle, and the importance of independent journalism. Dr. Anthony Youn joins the discussion, focusing on skincare and anti-aging. He emphasizes the significance of starting a skincare routine early, particularly with sunscreen to prevent skin damage. Youn discusses the importance of a balanced diet rich in antioxidants and nutrients to combat aging, recommending collagen supplements and fermented foods for gut health. The conversation transitions to cosmetic procedures, with Youn highlighting the risks associated with certain treatments, such as fillers and Brazilian butt lifts (BBLs). He warns against the dangers of unregulated procedures and emphasizes the need for patients to choose qualified professionals. Youn also discusses the rise of body modification and the blurred lines between cosmetic surgery and extreme body alterations. Youn shares insights on effective cosmetic treatments, including micro-needling and red light therapy, which can improve skin texture and collagen production. He advises caution with popular procedures like thread lifts and emphasizes the importance of realistic expectations regarding cosmetic enhancements. As the discussion wraps up, Youn stresses the value of non-invasive treatments and maintaining a healthy lifestyle to promote natural beauty. He encourages viewers to prioritize their health and well-being over extreme cosmetic alterations. Kelly concludes by inviting viewers to tune in for future episodes, highlighting the importance of open dialogue on these topics.