What is Gender Confirmation Surgery?
Gender confirmation surgery, or gender affirmation surgery (GAS), is a surgical process that alters the body’s physical characteristics to align with an individual’s gender identity. This may include:
- Genital reconstruction surgery
- Orchiectomy or hysterectomy and oophorectomy
- Breast augmentation or reduction
- Facial and body structural modifications to match the desired gender
The goal of gender confirmation surgery is to help individuals with gender dysphoria have a body that aligns with their gender identity, reduce psychological distress, increase confidence in daily life, and improve overall quality of life.
Gender Dysphoria According to DSM-5: Symptoms, Diagnosis, and Treatment Approaches
Gender Dysphoria is a condition where an individual experiences significant discomfort or distress due to the incongruence between their experienced gender and assigned sex at birth. According to the DSM-5 criteria by the American Psychiatric Association (APA), symptoms must persist for at least 6 months and impact daily life, such as work, social interactions, or personal relationships.
The following characteristics may be observed:
- Strong efforts to eliminate physical sex characteristics that do not align with the experienced gender, such as a male with gender dysphoria using hormones, surgery, or other methods to suppress male physical traits
- Strong efforts to express characteristics of the other gender, the experienced gender, such as a male with gender dysphoria using hormones, breast augmentation surgery, or dressing as female
- A strong desire to be treated as the gender that matches their experienced gender, such as a male with gender dysphoria avoiding or feeling very uncomfortable using men’s restrooms in public but feeling more relaxed using women’s or gender-neutral restrooms
- A strong conviction that they have the feelings and responses typical of the other gender
Conditions and Evaluation Process Before Gender Confirmation Surgery: What You Need to Know Before Deciding
Gender confirmation surgery is a complex and high-risk procedure that requires thorough evaluation before surgery to minimize errors and long-term psychological impacts. Proper preparation helps ensure that the decision aligns with the medical condition and the individual’s true needs.
Requirements Before Undergoing Gender Confirmation Surgery
1. Living in the Gender That Matches One’s Identity
Before undergoing gender confirmation surgery, the patient must live in society according to their gender identity continuously for at least 12 months, which includes:
- Dressing and expressing oneself according to the desired gender
- Using names and pronouns that match the gender identity
- Being able to carry out daily life without social, family, or work-related problems
2. Hormone Therapy
Hormone therapy is an essential part of gender transition before surgery and must be supervised and monitored by a specialist physician to help the body adapt to the desired gender and reduce psychological stress.
3. Psychological and Psychiatric Evaluation
Gender confirmation surgery must be approved by at least 2 psychiatrists to verify that:
- The patient truly has gender dysphoria
- There are no other psychiatric conditions that could affect decision-making
- The patient has the ability to adapt and is ready for permanent physical changes
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Dr. Danai Rattanachai
Psychiatry
