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Long term implications of chest reconstructions are several. Important for the patient to remember that this is irreversible procedure. The patient will not be able to breastfeed in the future. And to the majority of the patients, they are going to lose completely the sensation in the nipples. Because we are disconnecting the nipple completely off and reducing the size and the thickness, we are placing them back in. Most of the times, their nerves do not grow in and therefore they will be completely numb or somewhat numb.

I still have my male anatomy, but I embrace femininity on my own terms. I don't desire to have a vagina or be like other women. I simply want to express myself in a feminine way.

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.

Microneedling is a method that involves using a small roller to puncture the skin and stimulate collagen production. This process may cause temporary redness. During microneedling, a facialist can insert various substances into the pores. One of these substances is derived from the foreskin of a Korean baby.

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.

Microneedling is a process where a roller is used to rupture collagen in the skin, resulting in a temporary burn-like appearance. The roller is then used to push a substance into the skin, typically an extraction from a piece of skin taken from a young person. In this case, the substance is foreskin from a Korean baby.

"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."

- "Puberty blockers are a group of medications or hormones that we use in the transgender population to stop puberty from progressing." - "We call them in endocrinology gonadotropin releasing hormone analogs or agonists." - "Their job is to really interfere with the signaling from the brain to either the ovaries or the testicles that produce the hormones." - "When somebody starts puberty, we can use them to stop the puberty from progressing, thereby allowing somebody to really explore their gender without the pressure of having secondary sex characteristics that are often permanent." - "And the really nice thing about puberty blockers is that they are reversible, so it's a really nice way for an adolescent to be able to explore their gender." - "We like to use them in birth assigned males who have already even gone through a full male puberty because they are able to then use a lower dose of estrogen."

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.

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.

Dr. Potter is speaking with an unnamed doctor from United Healthcare to discuss a patient's breast reconstruction. Dr. Potter wants to understand why United is denying coverage for a procedure to preserve sensation, involving dissection of the fourth intercostal nerve and grafting it to dermatosensory elements on the nipple. Dr. Potter requests the evaluation and reasoning behind United's decision, including the data and literature they reviewed. The unnamed doctor states that they cannot provide their name due to security reasons and that the information Dr. Potter is requesting is an internal resource and cannot be emailed. Dr. Potter expresses concern that United is making a medical determination, questions how that process works, and states that recent data from 2023 and 2024 supports the procedure's effectiveness. Dr. Potter will file an internal appeal.

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.

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.

For bottom surgery, hair removal is extremely important. For hair removal for a vaginoplasty, you can use laser. And because we're usually using penile inversion vaginoplasty, we need that hair to be removed because that's going to be the inside of the new lining of the cavity. Not only do we not want hair in there, it also can cause a lot of complications. So we go through that with you before, and then we do many hair checks as well to make sure that you're on the right path.

The speaker explains the process of a surgical abortion. After the cervix is stretched open, a suction tube is used to remove the fetus. A sofa clamp is used to grasp and remove the limbs, intestines, spine, and organs. Extracting the baby's head is the most challenging part, and it is crushed to ensure its removal. The abortionist then removes skull pieces and the placenta, and scrapes the uterus lining for any remaining tissue. Once all parts are accounted for, the abortion is considered complete.

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.

I prefer male pronouns and presenting as male. I want to either have no genitalia through nullification surgery or have female genitalia. Even if I don't have testicles, I would still take testosterone. My husband and I haven't decided on surgery, but I have started tucking and binding my genitals, which has been life-changing for me.

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.

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.

Michigan Medicine strives to be a safe, welcoming place for transgender individuals and to provide excellent health care regardless of gender. The goal of this video is to improve the comfort and competency of frontline staff in caring for transgender individuals. We will start by talking about gender identity, challenges the transgender community has faced in the health care system, and Michigan's policies regarding gender non-discrimination. The second half of this training is job specific. To discuss gender identity, it is important to understand the difference between sex and gender. Sex refers to one's reproductive organs, native hormones, and chromosomes, while gender identity refers to one's internal sense of gender, a person's basic sense of being a man or boy, a woman or girl, or another gender. Gender identity can be expressed by how individuals present themselves socially, including clothing, physical characteristics, speech, and mannerisms. All people, whether they are transgender or cisgender, meaning not transgender, have a gender identity and expression. Transgender is a term for individuals whose gender identity differs from the gender identity typically associated with their sex assigned at birth. There are many identities that fall under the umbrella of transgender. Transgender men, trans men, or trans masculine refer to people who are assigned female sex at birth but identify as men or masculine. Transgender women, trans women, or trans feminine refer to people who were assigned male sex at birth but identify as women or feminine. Other individuals may identify as genderqueer, agender, genderfluid, two spirited, bigender, or another identity that does not fit neatly into the categories of men or women. All major American medical societies, including the American Medical Association and American Psychological Association, endorse gender affirming care as the standard of care for transgender individuals. This means caring for people in a way that supports their gender transition and gender identity. Transgender people may undergo any one of a number of gender affirming medical interventions, including hormonal therapies like estrogen, testosterone, or hormone blockers, and surgical treatment to change body contours or genitalia. However, it is important to note that one does not have to undergo any medical or surgical treatment to be transgender. Some people are easily read as the gender they affirm while others are visibly gender non conforming or androgynous appearing.

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.

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.

- "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."

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.

A doctor states that roughly 50% of the baby girls he delivers require an operation to remove and reshape a penis and testicles, adding that five of his seven daughters had the procedure. He claims Louise, one of the first babies he delivered, has dating problems. Another doctor accuses him of mutilating over 2,000 little boys by performing this surgery. The doctor responds that they weren't boys, but little girls trapped in little boys' bodies, and that boys are bad.