I change and my body changes
No longer a woman
Masculine transsexuals (from women to men) may have a histerectomy (uterus removed), ovariectomy (ovaries removed) and mastectomy (breasts removed), in a total or partial way, to eliminate feminine organs.
There are three levels of histerectomy: partial (uterus removed), total (uterus and cervix of uterus removed) and radical (uterus, cervix of uterus, fallopian tubes and ovaries removed) that includes ovariectomy. The radical procedure is used to prevent someone suffering any desease of the feminine reproductive system and also to avoid a policystic situation resulting from the use of hormonal drugs.
Hormonal treatment is the taking of testosterone. Testosterone is a male hormone. It is secreted principally in males testes but is also secreted in smaller amounts by the adrenal glands and ovaries. As masculine transsexuals do not have testicles, man made testosterone has to be given. Once you start hormonal treatment you cannot come back to your initial appearance. People who take testosterone say it produces a calcium concentration and it is very common have problems in the kidney and vesicula, and also heart problems with a tendancy to heart attack.
Mastectomy is the procedure for removing breast tissue, partial or total. It is a procedure in which one or both breasts are removed from the body. Simple mastectomy removes gland, mamae, areola and nipple. Radical mastectomy removed also linfatic glands and part of chest muscules.
Becoming a man
The procedures to become a man are metoidioplasty and phalloplasty. With the effects of testosterone treatment, the clitoris enlarges, over time, to an average of four or five centimetres. In a metoidioplasty the enlarged clitoris is released from its position and moved forward to more closely approximate the position of a normal penis. In some cases the urethra is lengthened to end at the tip of the neophallus. The labia majora (vulva) can be united to form a scrotum, where prosthetic testicles (usually made of silicone) can be inserted. If a metoidioplasty is performed without a urethral lengthening or scrotoplasty (formation of a scrotum from the labia majora), this is sometimes called a clitoral release. This is less expensive than a complete metoidioplasty but does not allow for urination (through the new penis) while standing. However this also offers surgery with less risk because the urinary system remains unaltered without a urethral extension and still affords some of the visual effects of a complete metoidioplasty. The advantages of this procedure are that penis appears natural and is sensitive erotically, but small. Disadvantages are that the penis cannot be used for penetration and also it is necessary to have received hormonal treatment before the metoidioplasty.
Phalloplasty referes to the (re)construction of a penis. In any of the techniques available scars are numerous and it is also necessary to undergo many surgeries before acheiving the final appeareance, some of them very painful. This procedure also has complications, as with any surgery, and in most of the cases there is not sexual pleasure. There is also a risk that the skin used to create the penis dies, in which case you will lose all the reconstructed penis.
If you do not wish to risk the surgery, prostheses are available as an alternative.
No longer a man
The procedure for feminine transsexuals (from man to woman) has many levels. Regarding hormonal treatment, first is necessary to take anti-androgens in order to block masculine sexual hormones (androgens), and then one would start to take estrogens. Anti-androgens should be taken for at least 2 or 3 years in order to acheive feminisation. At a hormonal level, it means that the testicles do not function anymore and also do not excrete androgen hormones. Estrogenization does not have a specific time frame to see results, it depends on each individual and how the body reacts to the hormonal stimulation. In some cases it takes much more time than in others, depending on physical characteristics, age, eating habits, sports participation, adictions (alcohol, cigarettes, drugs), and so on.
In all cases, taking hormones have secondary effects that including loss of energy, chronic fatigue, less hemoglobin in the blood, fainting, loss of consciousness, problem with penis erection and other side effects like heart problems, kidney problems and also weight gain, cancer and diabetes. To minimise complications it is recommended to have a healthy diet, keep fit, take exercises, control your weight.
It is important to say that hormones do not affect the complexion and also do not change the tone of the voice. Voice changes as a result of hormones is only possible for a woman changing to a man. To change the complexion is necessary to have plastic surgery and to change the tone of voice it is necessary to have voice coaching.
Any hormonal procedure should be supervised by a doctor, but as the trans population has limited access to health services, especially in countries where there is strong discrimination against them, these procedures of change are often made without supervision, putting peoples lives at risk.
To be a woman
The operations that are necessary to become a woman are breast implants and vaginoplasty. Breast implants are prostheses that give greater size to the breasts, which may have previously been completely flat. Artificial breast may be made of saline or silicone gel. The risk is that they could deteriorate with the passage of time and break up causing infections. The advantage is that the feminine appereance is more real. Sometimes implants are added to other parts of the body such as the hips, buttocks and cheekbones. Even though the appereance may be satisfactory, the risk to health is very high.
Vaginoplasty is the procedure that essentially turns the penis into the vagina. During vaginoplasty the right spermatic cord is clamped and ligated. The primary incision is continued up the ventral side of the shaft of the penis. Then the anterior flap is developed from the skin of the penis. The urethra is dissected from the shaft. The corpora cavernosa are separated to assure a minimal stump. The skin flaps are sutured and placed in position in the vaginal cavity. The preservation of the vaginal cavity is assured by the use of a suitable vaginal form. Labiaplasty is a frequently used procedure where labia and a clitoral hood are created.This is often performed a few month after the first part of the procedure, and is an elective procedure. There are minor complications which include infections, bleeding and loss of grafted skin. The more serious complications include major infections or bleeding and damage to the bladder. There are good results in this procedure with some erotic sensitivity, but it is necessary to consider the risk as with any operation.
After surgery it is necessary to use expanders to prevent the new vagina closing. This procedure is continuous, and will have to be done daily. Use of lubricant is indispensable after the operation, later it can be stopped.
References
http://www.hombrestransdechile.cl/Pags/Pasos.htm
http://en.wikipedia.org/wiki/Phalloplasty
http://en.wikipedia.org/wiki/Metoidioplasty
http://en.wikipedia.org/wiki/Vaginoplasty
