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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.

There are over 100 gender identities, apart from male and female. Some individuals may identify as two different genders or as bigender. Others may describe themselves as gender queer, not wanting to be associated with any specific gender.

"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."

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.

All of these women have XY chromosomes and a condition called androgen insensitivity syndrome. Typically, females have XX chromosomes and develop female sex organs, while those with XY chromosomes develop male organs if sensitive to androgens. In this case, the women appear female but also have male organs internally. They usually remain unaware of their condition until adulthood, often discovering it when they don't start their menstrual cycles like their peers. A doctor's examination, such as an MRI, reveals their true chromosomal makeup, leading to confusion as they have identified as women throughout their lives.

I met Venezuelan migrants in the US who transitioned for free after crossing the border. They were able to choose their gender identity upon arrival.

In 1978, when Brenda was almost 13, Dr. Mone tried to convince her to have a vaginal surgery. He brought in a transsexual to show Brenda someone who had willingly undergone the operation, hoping it would persuade her. Some experts believe this was a reasonable approach.

All of these women have XY chromosomes and a condition called androgen insensitivity syndrome. Typically, women have XX chromosomes and men have XY. In this condition, if the body is not sensitive to androgens, male sex organs do not develop properly, and female organs may also be underdeveloped. Despite having male organs internally, these women appear outwardly female. Most do not discover their condition until adulthood, often when they realize they haven't started their menstrual cycle like their peers. A doctor's examination, such as an MRI, reveals their genetic makeup, leading to confusion as they have identified as women throughout their lives.

"For someone who is assigned male at birth and if they've already been through puberty, they could produce a semen specimen and have it frozen." "If someone is assigned female at birth and they are also all the way through puberty, you can do egg banking, which entails a little bit more." "Typically, you have to take some additional hormone injections and it's a procedure to go in and retrieve the eggs." "We think someone has to be probably in mid male puberty to produce semen." "There have been some case reports of transgender men who were assigned female at birth who weren't completely through puberty and have been able to do fertility preservation, but we don't know if that applies to everybody." "We definitely counsel all of our patients about fertility preservation." "Usually from their first visit, we're starting to talk about it."

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.

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.

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.

There is a community called trans abled where people who are physically able-bodied identify as disabled. For example, a man with two arms may feel like he should have only one. This has nothing to do with gender identity but rather someone's self-identity. It is considered a mental diagnosis called aptaminophenia, where someone is fascinated by having a missing limb or part of a limb. Some may find this idea strange or kooky.

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.

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.

Brenda was shown explicit birth photos to make her understand her gender, which shocked her as a young child. Doctor Money then tried to convince her to have surgery to construct a vagina, but Brenda was uncomfortable with the idea. She was told that the surgery would fix her genitalia and make it easier for her to pee. Brenda was scared and didn't understand why she needed surgery when she felt perfectly fine. She believed that the surgery would change her for the worse.

- "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.