Gender affirmation surgery refers to procedures that help people transition to their gender. Gender-affirming options may include facial surgery, top surgery or bottom surgery. Most people who choose gender affirmation surgeries report satisfaction with results, including the way their body looks and works and improved quality of life.
Gender affirmation surgery includes several procedures that may help your body better align with your gender identity. Unlike sex assigned at birth (either male or female), gender identity is the way you understand your body and present yourself to others.
Gender affirmation surgery may be an option if your sex assigned at birth differs from your gender identity (gender incongruence). It may help if you experience psychological distress because of gender incongruence (gender dysphoria).
Surgery is just one possible way to transition.
There are nonsurgical gender-affirming medical options, too, including:
Not every trans or gender-diverse person’s journey involves medical transitioning. Expressing your gender identity may also (or only) involve nonmedical changes, like:
Surgery types include:
Examples of gender-affirming surgery for people AFAB, such as for transgender men and transmasculine nonbinary people, include:
Examples of gender-affirming surgery for people AMAB, such as transgender women and transfeminine nonbinary people, include:
Approximately 25% to 35% of trans and nonbinary people in the United States receive gender affirmation surgery. According to a 2023 study, the most common surgeries are top surgeries, followed by bottom surgeries and facial reconstruction surgeries.
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You’ll work with healthcare providers to ensure you meet the criteria for gender-affirming surgery, according to the World Professional Association for Transgender Health (WPATH) standards of care. This organization promotes evidence-based care for transgender and gender-diverse people.
Many insurance companies require you to submit documentation related to WPATH criteria before they cover surgery costs.
To prepare for the procedure, your provider will review your medical history to ensure you’re in good physical health. They may perform various tests, including:
Your healthcare provider will walk you through what’ll happen during surgery. For many people, gender affirmation surgery is a combination of procedures. For example, you may have both an orchiectomy and a vaginoplasty, a hysterectomy and a phalloplasty, etc.
Regardless of the procedure, your surgeon will administer anesthesia so you don’t feel any pain. Depending on the surgery, your surgeon will:
Reach out to your provider if you have any questions about the specifics.
Some procedures take place in a single day, while others require several surgeries spread out over time. For example, top surgery usually takes one day. But a phalloplasty is usually spread out over several surgeries.
Even if surgery only takes a day, you may need to return to your provider for additional changes (revision surgery) depending on how satisfied you are with the results. Choosing a healthcare provider with extensive experience performing a particular surgery will reduce the likelihood you’ll need a revision.
It’s essential to talk to your healthcare provider beforehand so you understand:
The following healthcare providers may make up your gender affirmation surgery team:
You’ll need to take extra care of yourself as you heal. This may mean asking friends or family to help during recovery. After surgery, you’ll need to:
Gender affirmation surgery may help in those areas where your gender feels out of sync with your body. Surgery can enable you to become more satisfied with your:
Different procedures carry different risks. For example, individuals who have bottom surgery may have changes to their sexual sensation or trouble with bladder emptying. In general, significant complications are rare, as long as an experienced surgeon performs the procedure.
With any surgery, there’s a small risk of complications, including:
Recovery times vary based on what procedures or combination of procedures you have:
After surgery, it’s a good idea to continue seeing a mental health professional with a background in transgender care. They can support you as you adjust to life after surgery.
Research consistently shows that people who choose gender affirmation surgery experience reduced gender incongruence and improved quality of life. Depending on the procedure, 94% to 100% of people report satisfaction with their surgery results.
Gender-affirming surgery provides long-term mental health benefits, too. Studies consistently show that gender affirmation surgery reduces gender dysphoria and related conditions, like anxiety and depression.
Very few people who have gender-affirming surgery regret their decision. Research tracking the outcomes following gender affirmation surgeries shows that among people who opt for gender-affirming surgery, only 1% regret having the procedure.
Attend all follow-up visits to ensure you’re healing. Reach out to your provider if you notice signs of a complication, including:
Also, talk to your surgeon about routine aftercare. Depending on your anatomy, you may need regular visits with a gynecologist or a urologist. You may need routine checks for conditions like breast cancer, cervical cancer or prostate cancer. It’s essential to understand how surgery affects your care plan moving forward.
Gender reassignment is an outdated term for gender affirmation surgery. The new language, “gender affirmation,” is more accurate in terms of what the surgery does (and doesn’t) do. No surgery can reassign your gender — who you know yourself to be. Instead, gender-affirming surgery changes your physical body so that it better aligns with how you understand (and wish to express) your gender.
A note from Cleveland Clinic
All gender-affirming surgeries are major procedures. There are several steps involved and healthcare providers you’ll likely meet with, including your primary care provider, a mental health specialist and a surgeon. Assembling the right care team makes all the difference when it comes to your surgery results and your care experience.
Research the providers you choose carefully. Pick a mental health professional with expertise in treating transgender and gender-diverse people. Find a surgeon with several years of experience performing the surgery you want. Ask about their track record of achieving positive results. This may be one of the most important procedures of your life. Choose a team that can deliver the best possible care.
Last reviewed by a Cleveland Clinic medical professional on 12/13/2023.
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