The evolution of scientific names and gender reconfirmation are one of the effective measures to correct psychological and physical dislocation. When there is psychological and physical inconsistency, I'm afraid we can only change the latter. This is the so-called "a leopard cannot change his spots". After the appearance of ovarian transplantation and penile varus, the shape and function of transsexual surgery are more consistent.
Surgical indication
At present, the standards and requirements for operation are different, and the traditional operation is still too harsh because there are many defects. The author believes that human rights should be respected, transsexuality can be carried out as long as one wishes, and the household registration office and society should immediately recognize its social attributes after the operation. Only in this way can we embody the social-psychological-biomedical model. You don't have to stick to all kinds of rules and regulations, but you are pushing a distorted life and making these patients miserable.
situation
1. denaturation; 2. Voluntary request; 3. Patients have lived and worked openly according to their psychological gender; 4. Psychotherapy is ineffective; 5. The psychiatrist proves that his mental state is normal; 6. The household registration department conducts judicial appraisal and agrees to change the gender on the ID card after the operation; 7. The patient is very clear about what may happen after the operation and signs the informed consent form; 8. There are no surgical contraindications.
ask
1. The reconstructed female vulva is vivid and lifelike; 2. The vagina has enough depth and width after operation; 3. The clitoris and vagina have sensitive sexual sensory functions; 4. Breast shape is natural, harmonious and symmetrical; 5. The Adam's apple and beard disappear, and the craniofacial contour is feminine; 6. The abdominal spot after operation shall not exceed 65438±0cm;; 7. After the operation, the patient's physiology and psychology were completely unified, and she successfully lived, worked and studied as a woman.
way
It mainly includes penis and testicle excision, urethral displacement, artificial vaginoplasty, facial bone feminization surgery, such as breast augmentation and nose plastic surgery, chin plastic, zygomatic and buccal plastic surgery, thyroid cartilage reduction plastic surgery, tone adjustment, electrolytic or surgical hair removal, ovarian transplantation, etc. Of course, not every patient needs to do all the above operations, and usually several operations are selected according to the actual situation.
step
1, penis orchiectomy and urethral transposition artificial vaginoplasty: the patient took the lithotomy position of bladder and performed the operation under general or epidural anesthesia. (1) Suprapubic cystostomy, sterile urine bag and catheterization. ⑵ Formation of scrotum and penis flaps. ⑶ Excision of testis and epididymis. ⑶ The urethral cavernous body was separated, and the glans remained about 65438±0cm, which was located in the normal clitoris position. 5] Excision of corpus cavernosum. [6] Under the supervision of laparoscopy, the penis skin was turned over to fix the vagina. Once the female vulva is reconstructed and reshaped. Being the vagina is full of molds, and the dressing in the operation area is shaped and bandaged.
2, breast augmentation, autologous fat transplantation breast augmentation (see the relevant sections of this website). Prosthesis implantation is invalid.
3. Ovarian transplantation, see the relevant sections of this website. Hormone replacement therapy is ineffective.
4. Feminization surgery of the lower contour of the mirror: After the overall design of the whole face, it will be carried out step by step: forehead plastic surgery, nose plastic surgery, chin plastic, cheekbone and cheek plastic surgery and other facial bone and soft tissue plastic surgery.
5. Thyroid cartilage reduction and plastic surgery under microscope: design an incision under the armpit and separate the thyroid cartilage under the microscope. After the thyroid cartilage is fully exposed, the most prominent part of the wing plate of the thyroid cartilage on both sides (that is, the Adam's apple) is exposed and removed.
Differences in Antai's operation
1. The penis is turned over to be the vagina, and the traditional colon passage is cancelled to replace the vagina, so it is easy to get orgasm after operation and avoid complications and sequelae such as intestinal leakage, leucorrhea and abdominal scar.
2. Under the supervision and guidance of laparoscope, make a hole to fix the vagina, shorten the operation time and avoid collateral damage.
3. Autologous fat transplantation of breast is realistic, and there is no complication of prosthesis compression.
4. Thyroid cartilage reduction and feminization of the lower contour under the microscope have no scars.
5. Ovarian transplantation replaces taking estrogen, making patients become real "women".
Surgical expenses
1. penis and testis excision, urethral transfer and artificial vaginoplasty-30,000 yuan;
2. Ovarian transplantation-20,000 yuan
3. Breast augmentation with autologous fat transplantation-4,000 yuan;
4. Thyroid cartilage reduction and tuning-2000 yuan;
5. Electrolytic coating-1000 yuan;
6. Nose plastic surgery, chin plastic, cheekbone cheek surgery and other facial bone feminization operations-654.38+0 million yuan.