Definitions

Gender dysphoria (GD): The distress a person feels due to the experience of discrepancy between the cultural expectations based on the assigned gender at birth and their gender identity.

GRS – female to male

• Top surgery:  
  • Surgical removal of breast tissue and excess surrounding skin (mastectomy)
• Bottom surgery:
  • Surgical removal of the uterus and cervix (hysterectomy), the ovaries (oophorectomy), the fallopian tubes (salpingectomy) and surrounding structures.
  • Removal of the vagina (vaginectomy or vaginal mucosal ablation)
  • The construction of a penis by turning a flap of donor skin into a phallus (phalloplasty).
  • Turning labia majora into a scrotum, with or without testicular implants (scrotoplasty)
  • Lengthen and hook up the uretha inside the new phallus (urethroplasty)
  • Sculpting the appearance of a foreskin (glansplasty)
  • Possible a penile implant to allow erection

GRS – male to female

• Top surgery:
  • Breast construction (breast augmentation/breast mammoplasty) that is surgically performed when breast growth from hormone therapy is insufficient.
• Bottom surgery:
  • Vaginoplasty: The creation of both an outer and inner vagina by using skin and tissue from penis, as well as new opening for the urethra and the new opening of the vagina (introitus).
  • Vulvoplasty: The use of skin and tissue from penis to create all of the outside parts of a vagina (except for the vaginal canal). It includes the creation of a clitoris from the glans penis, inner and outer labia from skin on the penis and scrotum and the introitus
  • Orchiectomy: The surgical removal of testicles. After the testicles are removed, the amount of testosterone produced will decrease, resulting in safer hormone therapy due to the lower dose. 
• Feminization laryngoplasty: Voice therapy and Wendler glottoplasty, which is an effective pitch raising surgery.