SEX REASSIGNMENT SURGERY

        Sex reassignment surgery or SRS is the surgical procedure by which a transgender person's physical appearance and function of their existing sexual characteristics are altered to resemble that socially associated with their identified gender. It is part of a treatment for gender dysphoria in transgender people. In Berlin in 1931, Dora Richter, became the first known transgender woman to undergo the vaginoplasty surgical approach. On 12 June 2003, the European Court of Human Rights ruled in favor of Van Kück, a German trans woman whose insurance company denied her reimbursement for sex reassignment surgery as well as hormone replacement therapy. The legal arguments related to the Article 6 and 8 of the European Convention on Human Rights. This affair is referred to as Van Kück vs Germany, The Case Van Kück vs. Germany, June 12 2003. In this essay, three main parts regarding the Sex Reassignment Surgery will be discussed method, process and effect.

         The first main point is method or procedure that will be going through by the candidates to perform sex reassignment surgery. The procedure has very high rates of success when it is performed by responsible and experienced surgeons. Most surgeons follow the World Professional Association for Transgender Health (WPATH) standard of care. To be allowed to get SRS you will have to meet many requirements. Most surgeons require two letters of recommendation for surgery from either psychiatrists, therapists or psychologists recognized in the field of gender identity. These letters must state that the individual is an appropriate candidate for SRS.  People with HIV or hepatitis C may have difficulty finding a surgeon able to perform successful surgery. Many surgeons operate in small private clinics that cannot treat potential complications in these populations. Some surgeons charge higher fees for HIV and hepatitis C-positive patients.  Surgeons may require overweight patients to reduce their weight before surgery. Since you will lose blood, patients may be asked to donate two units of their own blood, just in case. An interview or consultation is given where you will be fully informed of the procedures involved in surgery and the implications of its irreversible nature. You will sign a written consent for sex reassignment surgery.

The second main point is the process of sex reassignment surgery on male-to-female surgery and female-to-male surgery. The common technique for creating a vagina is the penile inversion technique. Converting male anatomy to female anatomy requires removing the penis, reshaping genital tissue to appear more female and constructing a vagina. Surgery begins with the patient on her back, with their legs spread wide for good surgical access. An incision is made into the scrotum, and the flap of skin is pulled back. The testes are removed. After the testicles are removed, the surgeon needs to remove the parts of the penis that aren’t needed. A shorter urethra is cut. The penis is removed, and the excess skin is used to create the labia and vagina. Next, isolation of the nerve and vessel bundle and glans. Next, the urethra needs to be separated from the penile shaft. It is located inside the shaft, and once treed, it is shortened and positioned like it would be in female. Then, the corpus cavernosum, or evectile tissue of the penis need to be removed. After that, the creation and placement if the clitoris to maintain its attachment to its nerve and blood supply. Lastly, inversion of the penis skin by flipping the penis skin inside out, so that the external skin become the internal lining of vagina. The end of the tube is sewn shut, then a stents is used to reverse the skin tube.

              Female-to-male surgery procedure typically occurs in stages. During double Mastectomy, both breast need to surgically altered if they are to look less feminine. This process involves removing breast tissue and excess skin, reducing and properly positioning the nipples and areolae. Androgen (male hormones) will stimulate the development of facial and chest hair, also cause voice to deepen. Next, the uterus and the fallopian tubes are also removed and the next stages are genital transformation procedure. The urethra is rerouted to allow urination through the phallas. The Labia Majora will form the scrotum. During a scrotoplasty, synthetic testicles are implanted. A radial forearm flap, or an alternative portion of skin is used for penile reconstruction. Finally, hormones alter the amount of testosterone in a person’s body.

          There are several pros and cons effect that candidates will through after the Sex Reassignment Surgery (SRS).Firstly , the effect show in sexual satisfaction .Before perform the surgery , the candidates don’t want to make any sexual activities because of the unwanted sex organs . According to De Cuypere (2005) , the majority of the transsexual individuals have reported enjoying better sex lives and improved sexual satisfaction after sex reassignment surgery . After sex reassignment surgery, transsexuals tend to be less gender dysphoria .They also normally function well both socially and psychologically. Anxiety, depression and hostility levels were lower after sex reassignment surgery according to YOLANDA L.S. SMITH (2001) . Gender dysphoria or can be called as gender identity disorder (GID)  is the assigned sex and gender do not match the person's gender identity, and the person is transgender. Based on Islam religion , we can’t change our gender because it means that we do not accept the destiny determined by God . The next effect can be seen in term of psychological or  behavioral  that person . According to Jokić-Begić N (2014) , many patients perceive the outcome of the surgery as not only medically but also psychologically important. Social support can help them to relate to their minority identity, ascertain their trans identity and reduce minority stress. This show that psychological support is very important for the patients after the sexual reassignment surgery  because to helps them feel accepted and confident with the outcome of the surgery  . If the patients don’t get moral support from other , it will make the patients feel regret after the surgery and will it would be more harmful to the patient's condition . This evidence show us that there are have pros dan cons effect after the surgery that will effect the patient’s life .

          In conclusion,the three main parts method, process of surgery and effects were discussed regarding the gender reassignment surgery. The challenges that facing by the transgender community is lack of protection, poverty, harassment and stigma. So we should have some humanity to help them and give courage for them to facing the society.