Talk:Gender-affirming surgery

Merge proposal

Sex change should probably be merged into here since it doesn't have very much information which needs to be separate. At the very most, it should only be a sort-of-disambiguation-page (to show the difference between SRS and "mental" sex changes (such as hormone therapy, etc...)Nippoo 12:32, 6 April 2006 (UTC)

Disagree here. Sex change is a term that is (inappropriately) used to describe a lot of things, mostly SRS, but often the whole process of switching gender, sometimes GRS and so on. The article Sex change is simply needed to refute the most common uses, pointing out why the term is inaccurate. That is not the same as an article on SRS (or GRS, or whatever). --AlexR 04:38, 8 April 2006 (UTC)

MTF / FTM

I was thinking that perhaps MTFs and FTMs should have separate sections since SRS has so many surrounding topics for FTMs. I know both consistently get lumped together, but realistically, the surgical techniques and standards for FTMs are unfortunately decades behind those for MTFs and this is both relevant here and a topic which needs greater attention. Agree/disagree? I would love to see some one with better firsthand knowledge do this, but I suppose I could try to do it if no one else stepped forward. Any thoughts? Paige

I don't think that's necessary, especially not if there is no extra large article about both directions. After all, one can safely assume that most people looking up SRS on Wikipedia are not particularly interested in the latest techniques, but want more of an overview. Also, since most people tend to think of transwomen only if they think about transgender, I fear that that would lead to people reading the transwomen article and then stop. Counter-productive from my point of view ;-)

Seperate articles would also, if they are done and IMO, make more sense if not lumped together in a transmen and a transwomen article, but seperated by procedure. After all, an article about hysterectomy is not just interesting for transgender people. Same goes for breast enlargement.

I disagree with transmen technique being so much behind. It is just a much more complicated thing to do - as doctors say, "It's easier to make a hole than to build a pole!". After all, remember, the transmen techniques have been developed to give cismen back theirs when they have lost it. You can safely assume therefore that just as much research is being done ;-p AlexR 09:07 2 Jun 2003 (UTC)

Hi Alex, what I meant was possibly cleaning up the current article, just so we're not switching back and forth between procedures so frequently, which I think would be confusing to the uninitiated, and then expanding. And as far as equal effort being put forth for transmen, I just really haven't seen that. I've always seen the good ol' boy medical profession (though there are exceptions) as not wanting to let anyone into their private little clubhouse. I think it's shameful the lack of consideration that FTM patients seem to be given. The only reason any significant effort has been put forth on surgical techniques is precisely for applications for cismen, which is part of why they have never been adequately adapted for SRS. (Do you think the disparity is due to the left-over "male privilege" from that little M on transwomen's birth certificates? That would be ironic...and sad.) I only said the procedures were decades behind, because they are historically. Back when Christine Jorgenson was making headlines, transmen weren't being taken seriously at all. In fact, until fairly recently, MTF were the only ones usually talked about, and transmen were treated as a footnote. I guess I just think it's something that needs to be talked about. I feel that as long as my brothers aren't being treated equally, then no transsexual is being treated fairly. I know it seems silly and even counterproductive to divide the sections in order for us to support each other, so what do you think? Any suggestions? If you think it's fine the way it is, that's okay too. Thanks, Paige

Hi Paige! I think the neglect transmen are given is due to a combination of factors. One is that "women" were not been taken so seriously, certainly. OTOH, their "aim" was seen as much more "unterstandable" by a predominantly male profession, so that in practice the rules were often less stricktly followed (especially the more stupid rules) at least here in Germany. And of course, because of that, and because we were less obvious and therefore less of a thread, many people were, until a few years ago, quite content with keeping transmen on the side line.

As far as the Article is concerned, I still think that seperate articles for every procedure would be the best way to go, with the main article only having a list with very short definitions. In the German article I also put transmen first, and then transwomen. After all, it's so often the other way round. It also has a list first, and then short explanations, because I had too much to do to write long articles about each. I am also not exactly a specialist for surgery, because I am quite content with my own top-surgery only. http://de.wikipedia.org/wiki/Geschlechtsangleichende_Operation AlexR 16:13 2 Jun 2003 (UTC)

Regarding Standards of Care
It would be nice if the article stayed that way with regard to SOCs, and not get changed back again to a US-centric view. In many European Countries, the HBIGDA-SOC are not the SOCs usually used, but local SOCs exist. The HBIGDA-SOC would be a real improvement there, believe me!
And I am thinking that maybe it would be a good idea to put SOCs into a seperate article altogether. It is not directly related to surgery, and a seperate article would also provide the opportunity to cover the different standards better.
AlexR 23:56 4 Jun 2003 (UTC)

Good idea. The part about who Harry Benjamin was and what the HBIGDA does doesn't really fit in this article. It would also be interesting to discuss the trends seen in recent revisions of the SOC. And as you say, in many European countries at least the official care providers have their own protocols that are way behind the HBIGDA SOCs. -- Kimiko 07:22 5 Jun 2003 (UTC)

Thanks, Alex and Kimiko. My only problem with that is that the Standards of Care is the proper name of a specific document, so changing that is kind of like saying "Other countries use their own version of the Magna Carta," or "Other religions have their own Ten Commandments," you know? A Google search returns only one other document using the term Standards of Care that deals with GID, and that it also from the US, by a group called the Health Law Project and was written for the express purpose of rebutting the HBIGDA document. Can you cite an example of another set of guidlines that uses this title? Also, it should be noted that standards of care (common noun) is a term used throughout the medical industry for all types of topics, with a special focus on Psychiatry. So perhaps this could be said in a different way, as the current edit offers readers no additional info, but simply removes clarity from the factual points. What do you think? (Also, I'm going to do an HBIGDA page, hopefully today, and I'll move most of it, but this still needs to be worked out first) Thanks, Paige 12:20 5 Jun 2003 (UTC)

You could use protocol (as I did above) to describe other standards than the HBIGDA SOCs. At least, that's what it is called in the Netherlands. Protocol can also refer to anything, just like standards of care (no caps). -- Kimiko 13:54 5 Jun 2003 (UTC)

Alex, would you agree with this solution? It sure seems like a good one to me. Please let us know what you think so I can set up the HBIGDA article and move some of this there, okay? Thanks, Paige 14:30 5 Jun 2003 (UTC)

The German Standards of Care are explicitly called "Standards of Care", and as far as I know, other some other European SOCs are also called SOCs. So I'd stick to SOC and call the HBIGDA-SOCs explicitly so. Also, I have encountered the term "Standards of Care" many times when other illnesses were the subject, hearth attacks, for example, or diabetes.
Do you want to set up an article specifically about the HBIGDA-SOCs? I'd call it "SOCs for transgender/transsexuals", leaving room for both SOCs about other illnesses in other articles and other SOCs than the HBIGDA for transgender/transsexuals in the same article. Since the Wikipedia is an international project, I think those other Standards would be best put together with the most influential ones.
AlexR 15:58 5 Jun 2003 (UTC)

Alex and Kimiko, if you have a chance, please check out the changes I made and the new Harry Benjamin International Gender Dysphoria Association article. Thanks, Paige 14:37 6 Jun 2003 (UTC)

Hm, I would have put the standards in a seperate article, not under the heading of the HBIGDA. The HBIGDA should explain only the HBIGDA; after all, the standards are not the only thing they do. And, on the other hand, an article about SOCs under that heading would have provided the opportunity saying something about other SOCs. Plus, the information that SOCs for other illnesses exist have nothing whatever to do with the HBIGDA.

Also, I am getting fairly annoyed that the paragraph about transgender people who opt for SRS is constantly edited out. Not only transsexuals have surgery, and not all those who have surgery are transsexuals. Editing this information out invaldidates other people's life -- mine, for example -- and is definitely a violation of the NPOV! -- AlexR 17:12 6 Jun 2003 (UTC)

No harm was meant. That line simply makes the article confusing. If on Wikipedia, "A transsexual is a person who establishes a permanent identity with the opposite gender to his or her birth sex," and SRS is "the surgical procedure by which a person's physical appearance and function is changed to that of the opposite sex," then how are non-TG readers supposed to understand a person seeking SRS who isn't a transsexual? It's confusing. Either one of those definitions needs to be changed or some explanation should be given. Your life and your TG-identification is a very specific circumstance which places you as a minority (post-op TG) within a minority (TG), which probably warrants an in-depth discussion, right? Personally, I would find it much more apealing if you wrote a full paragraph explaining that under whichever article you choose, SRS, TG or TS. Readers will probably be interested in hearing WHY some choose the indentifiers they choose, don't you think? However, as it stands now, it only reduces the clarity of the definitions. My revision wasn't intended to be POV, it was purely 100% editorial.

Can you please expound upon that line so it becomes clear to non-TG readers at least? (Please double check the grammar as well. Themself needs to be plural to match the number of persons and it would be preferable if the independent clause did not begin with also.)

As for the HBIGDA-SOC being placed under the HBIGDA article, it was simply for organization. The two terms a very much linked, and since no one has actually provided any facts on the other SOCs, there isn't enough detail for two separate articles yet. If you could please flesh out your criticism of my "US-centric" focus on the HBIGDA-SOC with some details about other guidlines, protocols or SOC's, instead of just knocking what I wrote, it would solve the problem.

I think the line about SRS patients calling themselves TG instead of TS as well as the edits you want about other SOC's are only modifiers of the existing information. Isn't it kind of counterproductive to add modifiers without explaining them or adding any new facts. We should be expanding these articles, not just watering them down. By adding the info you keep referring to, you'd be increasing the level of detail, which is the exact opposite of what's happening right now, I think. Either way, I'm done editing this one because I don't want to make people mad. Sorry. Paige 20:04 6 Jun 2003 (UTC)

Hi Paige! I don't think the line is confusing, and the difference between transsexuals and transgenders can easily be examined from the corrospondung articles. (Although the TS article could, IMO, use a bit of clean-up; maybe I'll do that sometime.) Anyway, my life and being post-op transgender is by no means a special case. Transmen who do not identify as transsexual and who had upper surgery are quite common, not only in Germany (and being a founder of the only German association of transmen, I know many), but also, from what I hear, in other countries, including the US. It is therefore extremely annoying if one keeps reading that surgery=transsexual equation, which simply isn't one. I also know it's more common among transwomen to make that equation, although, from what I can observe, it is by no means as widespread as it used to be. This is not just a modifier, either, but an essential information. And it needs not much further explanation, because, as I said, if people want to know the difference, the articles about TS and TG are only one click away.
As for the HBIGDA article, I think it was quite clear from the information already present in the debate that other SOCs exist. Therefore to write an article that makes it impossible to add this information where it belongs looks quite US-centric to me. And no other information about other SOCs were provided yet because it makes sense to write about the HBIGDA-SOCs first, since they are the most widespread ones, and they can very well be used as reference. And I have to admitt that I did not see the need to hurry with information about the German SOCs (which are the ones I know best) because the information is probably not all that relevant to English speaking users, mur merely interesting. The other reason why I only wanted to point out the differences, and for that the HBIGDA-SOCs needed to be written about first. Also, other standards are not only used in Germany, not even predominantly. In fact, the only country I know where the pure and plain HBIGDA-SOCs are used regulary are the USA, in all other countries I know the guidelines or local SOCs differ.
As for any grammar or spelling mistakes, I apologise. Not only is English not my first language, for some reason I usually write in the middle of the night.
-- AlexR 20:31 6 Jun 2003 (UTC) I forgot to add: It was not my intention to keep you or anybody from working at this articles. It is just that I have had the transsexual vs. transgender debate far, far too many times - without ever having seen the point in it in the first place. By now, that may make my reactions more brusque that necessary in that particular stuation. No offense was indented. AlexR 07:42 7 Jun 2003 (UTC)

I copied the discussion re: HBIGDA and SOCs to Talk:Harry Benjamin International Gender Dysphoria Association, which seemed to me a more appropriate place. Please continue over there. -- Kimiko 20:41 7 Jun 2003 (UTC)

---

I cleaned up the article a bit and removed several bits and pieces that have nothing to do with SRS, like style guides for pronouns, adopting or fostering children after changing gender, and the rather astonishing idea that harassment of trans-people is limited to those without proper paper and changed genitals. I will try to work the first two bits into the TS-article. AlexR 14:45 8 Jun 2003 (UTC)

---

Am I the only one who finds the term "Sexual Reassignment Surgery" to be odd? I'd always heard "SRS" rendered as "Sex Reassignment Surgery". After all, one does not have one's "sexual" reassigned (although I must admit that "gastric resection" and "arterial graft" follow the same grammatical pattern). And then there's the folks in Montreal who prefer "GRS".

Go figure. MaggieL 00:09 22 Jun 2003 (UTC)

That's the way I heard it too. For now, I've made a redirect from "Sex reassignment surgery" to here. -- Kimiko 07:41 22 Jun 2003 (UTC)

I think the adjectival form is used simply to avoid any confusion between a person's sex and sex the activity. Some people explain the use of GRS as being more inclusive (eg it would be applicable to intersexed people who were transitioning). However, I always felt like it was saying that while you're making the body match the gender, you'll never actually be that sex since you cannot reproduce. I don't really like the term GRS for that reason. Paige 13:50 22 Jun 2003 (UTC)

To me GRS means literally reassignment of gender. Since gender is in one's mind, personality and behavior, it can not be reassigned by surgery and GRS is an incorrect term. SRS is the correct term since it is actually one's sex (ie. genitals and/or other body parts) that is reassigned. -- Kimiko 22:38 22 Jun 2003 (UTC)

What about intersex surgery?

The articles about intersex persons, such as myself, only talk about what has been typically done to us, but it doesn't say a word about surgeries to help reverse prior surgeries. I'm mostly interested in how they would be able to turn the surgeries I have had into something managable for surgeries to do the opposite. For example, I was given surgeries to force me to be female, but I want to live as a man. I would also like to know if it's possible to get transplants for things like erectile tissue, from a donor, and whether or not it would function more naturally than the prosthetics. (by User:Stef M)

Well, basically, there is no difference there to any other SRS, the options are exactly the same, so I am not sure whether there is any need to mention that seperately. When it comes to bottom surgery, you have exactly the same options (if what was done to you produced basically a "normal" female anatomy, at least) as exists for every transman and in fact every cisman who lost his crown jewels. Those do not include any donor tissues, as there are far too many complications involved, particularly with tissue rejections. Check with the nearest transmen group, they will know what kind of surgery is available in your country and what to expect as a result.

PS, and do sign your edits on any discussion page, please. Just type -- ~~~~ at the end of a posting. -- AlexR 05:07, 9 Sep 2004 (UTC)

That may help some, but what was done to me rearranged things enough that typical trans surgery is not able to be performed without severing every single nerve I still have that's able to feel anything at all. I've been recently tranferred to UC San Fancisco for endocrinology, and my new endocrinologist wants me to do some research into what centers may be be able to help me. I also recently sent a letter to the Intersex Society of North America in search of information, but have not yet received any. Would you happen to know of any centers in the US that may be able to help me? And thank you, by the way. -- Stef M

Sorry, but I can't help you with US adresses, because I am from Germany. Regarding surgery, those are the basic procedures, and as far as I know, there are no others, or they are highly experimental, and therefore probably just as likely to damage nerve endings. I'd just try to talk to people doing that surgery, they are probably the only ones who can tell you what is possible in your particular case. Of course, if you are really messed up, there might currently be no option for any bottom surgery. I know that sounds tough, but a lot of transmen also do not opt for bottom surgery because they do not like the results. We might not have what we want, but those of us who do not opt for surgery at least right now do consider what we have better or at least safer than anything surgery might produce. I really do recomment vontacting a transmen group near you. Many have already seen intersex people, too. -- AlexR 09:45, 23 Sep 2004 (UTC)

Needing Info.

Hi everyone,

I am a college student at South Dakota State U., and I am doing a research/huamn anatomy/awareness paper on sexual reassignment. I ws wondering if anyone could lend me a helping hand. I am looking for reliable sources of information. I haven't found too much,yet, and I have sent out about 50+ emials with just a few responses. I am looking for surgical procedures with pictures along with any pathological porblems that may occur with these types of reassignments. I would really appreciate any help that any of you have to give. Thanks.

Matt Anderson

SRS surgeons

Why are links to lists of SRS surgeons, which have been removed, "not the role of wikipedia"? That explanation has more than a few disturbing possible motivations, and not a single logical one I can come up with. —Preceding unsigned comment added by 24.41.80.220 (talk • contribs)

• I saw it had happened but kinda agreed with it. From WP:NOT#Wikipedia_is_not_a_mirror_or_a_repository_of_links.2C_images.2C_or_media_files;

There is nothing wrong with adding a list of content-relevant links to an article; however, excessive lists can dwarf articles and detract from the purpose of Wikipedia.

- Ali-oops^✍ 17:52, 6 April 2006 (UTC)

Given that the links to the lists of surgeons took up only a couple of lines in what is a relatively long entry, I don't see how one could possibly argue that they dwarfed the article or were in any way excessive, were not relevant to the article, or detracted from the article in any obvious manner. In short, your quote does not seem overly relevant. Mind you, in the end I could care less if the links are included or not, I'm just curious as to how those specific links could possibly be "not the role of wikipedia". —Preceding unsigned comment added by 24.41.80.220 (talk • contribs)

• Doesn't bother me, either. I was just pointing out what I believed to be the rationale (I didn't make the edit). If I was looking for a list of SRS surgeons, however, I don't think WP would be where I'd look - Ali-oops^✍ 20:55, 6 April 2006 (UTC)

I appreciate your response, I just don't feel your explanation is very... Illuminating. But, as you say, WP should be the last place one should look to for advice on an SRS surgeon (or, frankly, anything having to do with transsexualism whatsoever), so in the end it doesn't much matter. Mostly it was the just the odd specificity of the removal (why were only those specific links "not the role of wikipedia", yet the others are apparently okay?) and the, to my ear, rather ominious reason given for removing them.

I think the SRS surgeon's list should stay. It's not a place to look for advise, but, certainly a place for resource.

I feel that SRS surgeons can be listed on the page. why not? I'm adding some myself.

Semantics

Pardon me if this question has been addressed before or if it’s just too silly, but I was curious as to the semantics for the use of "reassignment" in this case. I understand that the evolution parts of the English language, at least in the United States has accelerated disproportionately in the last 40-years, much of it driven by social politics. I recall when this procedure was called a "sex change". Was "change" changed/reassigned to "reassignment" for any particular reason? Would acknowledging that sex is "assigned" in the first place also be an acknowledgement of a "Creator"? I ask half in jest, but I truly am curious.--69.118.159.140 19:47, 14 July 2006 (UTC)

That's a very interesting question. I think the term "sex reassignment" is used because babies are usually assigned to one sex at birth, by their doctors and/or parents, usually based on the appearance of their genitals. That said, I don't think acknowledgment of an assigned sex is an acknowledgement of a creator. A person's sex is "reassigned" when they go through transition, but most transsexual people consider there to be much more to sex and gender than the appearance of the external genitals. See the article on sex change for reasons why this term is often considered incorrect for referring to SRS. I think better terms for the genital surgery itself would be "genital correction surgery" or "genital reconstruction surgery." The term "sex reassignment" has been used since the 1950's, but "sex change" is the only term known by many people unfamiliar with transsexualism.

Andrea Parton 23:24, 14 July 2006 (UTC)

Results / Orgasm

The current section on results metnions that people who take the surgery cannot reproduce, but it doesn't say anything about how the genital nerves are affected and whether and how post-ops can enjoy sex. Some info? Redge(Talk) 16:48, 20 August 2006 (UTC)

The following is what existed prior to it being deleted on June 2, 2006 in the article orgasm:

Transwomen

Post-operative male-to-female transsexual women (having undergone vaginoplasty) generally experience full orgasm, involving any combination of the clitoris, vagina and labia.

Some transwomen experience female ejaculation, which can be from the prostate gland, seminal vesicles, and/or Cowper's glands, which are not removed during vaginoplasty.

Transmen

Post-operative female-to-male transsexual men (after having undergone metoidioplasty, or phalloplasty) generally experience orgasm in the same way as other men, except that those who have had phalloplasty have a pump installed to create an erection, as the neopenis (with either surgical technique) has limited natural erection capability. Due to the lack of the necessary glands, they do not have the ability to ejaculate.

It is my understanding that if a phalloplasty is performed and the clitoris is not retained, then orgasm is almost nonexistent in post-operative transmen having undergone phallo (again, without retaining the clitoris). Someone more knowledgeable on phalloplasty needs to comment on this to confirm or clarify. -- WiccaIrish 07:58, 22 August 2006 (UTC)

The current article regarding orgasm is not cited and, as a post-op TS is, IMO, mis-leading, I rarely climax. Raquel Baranow (talk) 02:20, 1 April 2009 (UTC)

That section does indeed have many problems. I have removed more of the unsourced claims from it.— James Cantor (talk) 11:31, 1 April 2009 (UTC)

Thx for cleaning up all those weasel words in that long section too. I just did an internet search of Transsexual + Orgasm, there isn't anything really new or conclusive, IMO. Doctors & patients may tend to exaggerate. Raquel Baranow (talk) 15:14, 1 April 2009 (UTC)

Surgery Images

Hi,

In my site I have images from a sex reassignment surgery. I think the images are of great value especially for someone who has to undergo such an operation. If you think so too feel free to add it in the external links section

http://surgery-images.com/sex%20reassignment/male%20to%20female%20sex%20change.html Nfostiras 15:06, 6 November 2006 (UTC)

Warning: Explicit surgical images. Exploding Boy 16:56, 6 November 2006 (UTC)

That site is no longer functioning. There ain't nothin there but a placeholder now. —Preceding unsigned comment added by 76.125.225.189 (talk) 05:27, 8 December 2008 (UTC)

Time for a change

Uhh, how do you do an article on this without mentioning when the surgery was first done, who by, & on whom? RuPaul 16:01, 21 February 2007 (UTC)

I haved added a History section and some information on Lili Elbe. Fluffball70 11:48, 24 March 2007 (UTC)

I don't think Elbe was the first MtF to be operated on. According to R. Muehsam in 'Chirurgische Eingriffe bei Anomalien des Sexuallebens: Therapie der Gegenwart' (67: 451-455) published in 1926, Hirschfeld referred the first male-to-female patient to a surgeon, Dr. Felix Abraham, in 1920. In 1921 the first private surgeon, Dr. Gohrbandt, began to practice early forms of sexual-reassignment in Berlin. These initial attempts at SRS were incomplete, usually entailing simply the removal of the sexual organs of the patient. Further enhancements to the procedure were developed in the following years. Most notable were the first attempts at vaginoplasty. Initially vaginoplasty was performed using skin grafts from the legs and/or lower abdomen. In 1923 the first MtF sexual-reassignment operation was performed in Europe (don't know who, but perhaps the patient that was referred by Hirschfeld in 1920).

The earliest genital masculinization surgery was in 1882, the patient being Herman Karl. Then came Dr. Alan Hart in 1917-1918 who underwent a hysterectomy. -- WiccaIrish 06:13, 25 March 2007 (UTC)

Clean-up, citations, and new section suggestions

Just a heads up: I'd like to start improving this page. Several things that I'd like to include:

• History of intersex procedures and History of Transsexual procedures
  • As one inevitably led to the other, and "SRS" is still practiced on intersex infants, although a WP:POV way of putting it would be genital mutilation
  • Famous first surgeries; in 1940, the first transsexual surgery, in 1953(?) first in the UK, in 1960s, first in the US
• MTF Surgery
  • What's involved (Basics - not detailed)
  • What procedures have been developed
  • Functional outcome (there are a few medical articles on this, but they are not great quality)
  • I think there's an old picture of one of the first peno-scrotal flap vaginoplasties floating around the support site - if anyone can see if it's fair use that would be helpful
• FTM Surgery
  • What's involved, what procedures are offered (Basic, but including different styles, oophorectomy vs hysterectomy vs phalloplasty with testicular prosthesis vs clitoral release (metoidoplasty, etc.) (don't forget mastectomy)
  • Functional outcome (which as I understand canbe quite poor, with considerable morbidity
  • The pros and Con's of the various flap phalloplasties - If anyone can supply pictures of THE DONOR SITE (not the recipient site, lol) that would be useful
• Reproductive issues
  • Sperm Banking (MTF)
    • And the resultant legal issues when a lesbian MTF wishes to impregnate her female partner, perhaps?
  • Ovarian Tissue Banking (FTM)
• Legal recognition
  • With, of course, a link to the main article legal aspects of transsexualism
  • What countries give birth certificates, what countries/states/cities are known not to recognise SRS
  • The few cases where SRS is recognised in general, but not in specifics (i.e. marriage - as a side note, some people in the US and UK have had their post-transition, heterosexual marriages overrulled, and essentially been told the only legal marriage they can enter into is a same-sex one!)
• Opposition to SRS
  • E.g. Janice raymond (SRS is evil and a blight on feminism), Kate Bornstein (SRS is giving in to the dictomatous gender paradigm), any others worth mentioning?
• Medical Funding of SRS
  • Where it is and not considered "merely cosmetic"
  • if there are any significant movement people should know about
  • Also a link to some of the media portrayal here? (i.e. i think there was a case where 6 pre-op transsexuals sucessfully applied for a US city council top include SRS on their health plan, only to have the media report it as 6000 possible surgeries being funded "by taxpayers" - San Fransisco, I think?

Any other comments or suggestions? I do think the article need cleaning up and verification, and it could quite possibly jump a class if we get onto it.

Cheers, Lwollert 00:47, 1 March 2007 (UTC)

biological gender

Other than people with sex genes other than XX XY, aren't you alway male or female? Even if you are born with genitalia inconsistent with your genes your genes will clearly definde your sex. I've read some articles on post operative ftm and mtf and they are referred to by their preferred sex. Having SRS doesn't actually change your sex, it only modifies your body to resemble the sex you desire. -- 146.115.73.181 09:06, 14 April 2007 (UTC)

You would need to define what is male and female. "Male" and "female" are labels given at birth after the nurses and doctor sees a seemingly "normal" genitalia. If you believe sex cannot be changed, I ask "why not?" What are the things that cannot be changed and why do they even matter? The chromosomes cannot be changed, but why does that matter and where does that leave those that are neither XX or XY? -- WiccaIrish 21:19, 14 April 2007 (UTC)

Once again, there is a difference between Gender and Sex. Each of these is defined in various ways. For instance, Sex can be defined as:

• • • Karyotype (Chromosomal sex) (can be indeterminate)
    • Gonad type (Ovaries Vs. Testies) (Gonadal Sex) (can be indeterminate or missing; see Streak gonad)
    • Hormonal status (Primarily circulating testosterone vs. Oestrogen and Progesterones) (Hormonal Sex) (Can be mucked up; see 5-alpha reductase deficiency, or even simpler PCOS, Hormone replacement therapy (trans) )
    • Body phenotype or Secondary sexual characteristics (Phenotypal sex) (Put simply, Boobs vs. Beard.) (But then there are bearded women and boobless women - and beardless men and boobed [sic.] men)
    • Genital phenotype or Primary sexual characteristics (Genital Sex) (Clitoris and Labia vs. Phallus and Scrotum) (See Intersex)
    • Internal Gender Identity (Feminine gender vs. masculine gender) ("Brain Sex") (That internal, fixed, and congenital sense of one's own gender; see Transsexualism)
    • Percieved external Gender (Feminine vs. Masculine) (Social Sex) (What people percieve you as; your function in society; a function of Gender)

And all of these, with the possible exception of brain sex, is widely used to define "Sex" - depending on what suits their argument. Transsexuals may define sex as being largely determined by hormonal status and genital phenotype. They may also define it largely by brain sex, or social sex. Intersex people may disagree that there is any binary structure they fit into.

In terms of SRS and transsexuals;

They are reffered to their preffered sex only recently; it has been deemed far less confusing than the DSM-III system where they were defined as homosexual or heterosexual types regarding from their previous social gender. (See Classification of transsexuals ) It is also a function of gender rather than sex; it is quite rude to ask someone "what anatomy is in your pants?, or as you suggest, "what is the nature of your karyotype?" when seeking to refer to them as a Mr. or Mrs. You don't do that in normal life, do you? and if you are worried that transsexual people do not "Pass" as a member of their gender, or that there is often ambiguity, see here.

"Desire" is not the appropriate term for transsexuals. "Need" is.

I would in fact agree that SRS is more body modification than transformation. But then, I am female despite what my gonads decided at birth, under instruction from my XY karyotype.

Hope I could be of help. Cheers! Lauren^♫/∆ 06:41, 15 April 2007 (UTC)

That's a great overview. Although there's also the internal reproductive organs and tissues (vas deferens, bulbourethral gland, epididymis, seminal vesicle, and prostate vs. vaginal canal, cervix, uterus, fallopian tubes, and fimbria.). Look at persistent müllerian duct syndrome and müllerian agenesis. -- WiccaIrish 08:01, 15 April 2007 (UTC)

Sexuality

Many people who have sex gender surgery claim that they are the same inside. eg a man who has the surgery to become a women is still a man inside etc... So if the man becomes a women and is then attracted to men doesnt that make that man gay? Becoming a women artificially qualifies you as being a women? Being born a man and liking men makes you gay (correct) ?