Gender Reassignment Surgery in Turkey Cost, Procedure and Statistics

A gender reassignment surgery adjusts the biological gender to the perceived gender. Read how it works and what the risks are.

If a person's biological gender and perceived sexual identity do not match, i.e. if a person is transsexual, a great deal of suffering can arise. Through a sex reassignment surgery, the technical term is sex reassignment surgery or GAOP for short, doctors can change the physical characteristics through hormone treatment and surgical interventions. From male to female or from female to male.

Today there are various feminizing and masculinizing procedures for gender reassignment. However, it is not easy to have an operation in the case of transsexuality. Affected persons must meet certain requirements for gender reassignment.

Conditions for non adults

First of all, there is an age limit for sex reassignment surgery. According to the guidelines minimum age of 18, is recommended for surgical treatment of transsexuality. Hormones are possible from the age of 16.

However, before hormones are used in adolescents who wish to have a gender reassignment – ​​first in the course of anti-puberty measures and then as part of gender reassignment measures – psychotherapeutic treatment is required first. This is all done to ensure that wanting to have a gender change is not just a phase.

The situation is still different if a child cannot be clearly assigned to “man” or “woman” at birth based on its sex characteristics. If characteristics of the male and female sex are present, so that, for example, the external appearance is female, but testicles form in the abdomen, but the testosterone from which the body cells cannot process, experts speak of intersexuality. Operations are possible here in the first few years or directly after birth.



Requirements for a GAOP in adults

Adults require two referrals confirming they are transgender and a notification of the need for a gender reassignment from a physician experienced in the transgender community who has worked with the patient for a period of time.

The "Standards of Care" of the World Professional Association for Transgender Health (WPATH) also recommend that those affected should have lived in the desired gender role for at least twelve months before gender reassignment surgery and should have undergone so-called opposite- sex hormone treatment for at least six months to eight months to have.

Which Doctor Performs Sex Reassignment Surgery

A gender reassignment is not only a big deal for the person concerned, but also a medical challenge. Accordingly, various experts work together in the process of gender reassignment , among other things, a doctor for plastic surgery will carry out the surgical intervention, if necessary supported by a urologist or gynecologist as well as vascular and nerve surgeons , an endocrinologist takes care of the hormone treatment in the case of transsexuality, and a psychologist takes care of it those affected on their literally life-changing path.

Sex Reassignment Surgery From Woman to Man

Gender reassignment surgery from woman to man involves several steps. Some of these steps are optional. Not everyone who wants to have a woman-to-man operation has to go through all the steps. Accordingly, gender reassignment from woman to man is always an individual process - and depends both on the wishes of the person who would like to have the surgery carried out and on whether gender reassignment surgeries have already taken place.

If the patient wishes, the doctors can adjust the genitals, for example in the case of a gender reassignment from female to male. Possible here are for example:

• Penoid construction: In order to construct a penis replacement, also known as phalloplasty , a very complex procedure is necessary. The doctors form a penis-like structure from the body's own tissue. A penoid is the closest approximation to a natural penis. If desired, an erection can be achieved with an erection pump.
• Clitoral penoid formation: If you decide to have a clitoral penoid, the procedure will be less complicated. The surgeons mobilize and stretch the clitoris and lengthen the urethra beyond the labia minora. This allows the person to urinate while standing after the surgery. The genitalia formed is quite short at about one to four centimeters, but stiffens when aroused, albeit without ejaculation.

To have the uterus and ovaries removed with surgery, to replicate a glans penis, to build up one or two testicular prostheses and a scrotum is also possible. For many, an important step in the process from woman to man is breast reduction or removal ( mastectomy ).

However, the surgical procedures are only part of the gender reassignment process. Psychotherapy should always have taken place for at least one and a half years beforehand and the person concerned should have taken opposite-sex hormones for at least six months . In addition, before the operation, the doctor has a conversation with the person concerned, in which he and the patient discuss which procedures are desired or useful or even possible, what the risks are and how the procedure will proceed.

Sex Reassignment Surgery From Male to Female

First part of the adjustment:
Similar to the "woman-to-man operation", various steps are also possible in the "man-to-woman transformation", but they are not mandatory. In addition to breast augmentation, which is done with hormones and, if desired, with the help of implants, the genitals are certainly one of the biggest physical changes in the gender reassignment from man to woman. The aim is to “remove” the penis.

Usually, the conversion from penis to vagina is based on the so-called invagination method, in which the surgeon turns the penile shaft skin inside. This creates a neovagina. The doctor forms the clitoris from the glans and the labia minora from the front part of the foreskin. After this first procedure, the trans woman has to keep the neovagina open using a device that resembles a vibrator.

Second part of the reassignment:
A few months later, the surgeon performs the second male-to-female gender reassignment surgery, during which he removes excess skin in front of the vaginal opening and augments the mons pubis.

Another possibility is facial feminization in the course of gender reassignment from man to woman. The procedure or the treatment depends on the individual wishes and requirements and should make the facial features appear softer. For example, the doctor can make corrections to the chin, nose, cheeks or lips.

As with female-to-male surgery, the person must have received hormone treatment and psychotherapy prior to male-to-female sex reassignment surgery.
 

Sex Reassignment Surgery Cost Turkey

Whether it's female-to-male surgery or male-to-female sex reassignment surgery, the costs are significant. Depending on the extent of the procedure, a gender reassignment operation costs between 5,000 and 15,000 euros in Europe. Sex reassignment surgery costs are %70 cheaper in Turkey.

If the corresponding therapeutic and medical evidence is available, the health insurance company must cover the costs for hormone treatments, psychotherapy and certain gender reassignment surgeries. In order for the gender reassignment to be paid for by health insurance, those affected must submit two independent medical reports confirming their transsexuality. Only then does the operation count as a “medically necessary measure”. This process is very lengthy.

Best Clinic For Gender Reassignment Surgery in Turkey

Gender reassignment surgery is highly complex and requires a doctor experienced in the field. The patient goes to a clinic for the procedure. Female-to-male gender reassignment surgeries may be performed by urology clinics, male-to-female gender reassignment surgery can be done at mastectomy (breast reduction) clinics, or generally plastic and aesthetic surgery clinics. Innovacare will help you find the best clinic in Turkey that will satisfy your needs.

After Gender Reassignment Surgery

After the operation, the patient initially has to stay in the hospital. Between one and three weeks depending on the operation . After a gender reassignment, you can go back to work after about four to six weeks.

Male-to-female sex is possible after a gender reassignment operation after the procedure has healed. Since nerves and blood vessels are preserved as much as possible during the operation, the trans woman can also have an orgasm after the sex change. How long the surgical vaginal plastic surgery lasts also depends on how regularly it is stretched, either with special sticks, or some doctors also recommend sexual intercourse.

Female-to-male sex reassignment is a bit more complicated. With a klitpen , i.e. a mobilization and stretching of the clitoris, sexual intercourse is only possible to a limited extent due to the size of the organ. If you have a penoid with an erection pump, you should be able to have sex after it has healed, and the penis can feel.

Fathering children after a gender reassignment is not possible for trans men because they lack the male sex organs (e.g. testicles, spermatic cords). Conversely, trans women cannot have children because they have neither ovaries nor uterus. There have been cases where women who still had their genital organs after sex reassignment to man gave birth to children. But that is very, very rare.
 

Risks of Gender Reassignment Surgery

As with any surgical procedure, a gender reassignment surgery can have consequences that are unwanted or even dangerous. In addition to risks such as infections, problems with wound healing or bleeding, these can be seen in male-to-female surgeries :

• Urethral skin fistulas: These are small holes that form in the new urethra. Urethral constrictions or bulges can also occur.
• Narrowing of the vagina: If the skin in the neovagina does not have a good blood supply, the risk of it contracting (stenosis) increases.
• Changed sexual sensitivity: Whether better or worse cannot be said in advance. However, since lust is not only something physical, but also involves the psyche, the new situation can (at first) be stressful for some transsexual people.
• Problems with implants: Breast implants can slip, infection can occur, or chronic pain can develop.

In the case of female-to-male surgeries , problems can primarily arise with the structure of the penis (penoid) , including a constriction between the existing and the new urethra, which the urologist then has to expand, as well as fistulas, i.e. small holes in the urethra and skin surface through which urine can leak. Very rarely, there are serious complications such as complete penoid loss after sex reassignment surgery.