If you have any questions or want to speak with one of our specialists from the Gender Identity Unit without leaving your home, or if you are outside Barcelona (Spain), you can request a remote visit by conference call through the following link.
WHAT IS TRANSSEXUALITY?
Transsexuality is an expression of gender identity in which people recognise themselves as belonging to the opposite gender to the one they were assigned at birth based on their physical characteristics.
A transsexual person is someone whose gender identity differs from the one attributed to them at birth based on their biological characteristics. It is important to highlight that transsexuality does not necessarily require surgical interventions or hormonal treatments to be valid; although many transsexual people choose these options to align their body with their gender identity.
Transsexual women
Transsexual women, also known as trans women, are individuals whose gender assignment at birth was based on their masculine physical characteristics, but who psychologically and emotionally identify with the female gender.
Transsexual men
Transsexual men, or trans men, are people who were assigned the female gender at birth due to their feminine physical characteristics, but who psychologically and emotionally identify with the male gender.
REQUIREMENTS FOR GENDER CONFIRMATION SURGERY
Anyone who wants to follow a gender confirmation process must meet a series of requirements for transgender surgery. This is because the changes the patient faces are irreversible.
· To be of age
· It is advisable to have undergone hormonal treatment, handled by a doctor, for a minimum period of 6 months, before gender confirmation surgery, although it is not an essential requirement if the person does not want hormonal treatment or there is a medical contraindication for it
· To sign an informed consent, of which you can request a copy, where you're informed of both the irreversibility and the complications of the surgery
HOW CAN WE HELP TRANS WOMEN?
FEMINISING GENITOPLASTY (VAGINOPLASTY) BY PENIAL INVERSION
The standard procedure for Feminising Genitoplasty or vaginoplasty is penile inversion. This type of gender affirmation surgery consists of creating a neovagina that will be covered using the inverted skin of the penis and scrotum. The goal of vaginoplasty is to create a genital complex that is as feminine as possible, both from an anatomical, aesthetic and functional point of view.
FEMINISING GENITOPLASTY (VAGINOPLASTY) ACCORDING TO THE PEDICULATED RECTOSIGMOID FLAP TECHNIQUE
Feminising Genitoplasty or vaginoplasty with pedicled rectosigmoid flap or colon-vaginoplasty is a surgical procedure that consists of using a section of the terminal large intestine (sigmoid colon) to provide a neovagina. This technique is only carried out in cases where penile inversion vaginoplasty is not possible. This may be either because the penis does not have enough skin, or because it is circumcised or for other reasons. In these cases, penile inversion vaginoplasty would not allow sufficient vaginal depth and therefore the pedicled rectosigmoid flap technique is used.
VAGINAL AESTHETIC SURGERY
Feminising Genitoplasty aims to achieve female genitalia, not only from a functional and anatomical point of view but also from an aesthetic point of view.
During the intervention in which the Feminising Genitoplasty is performed (either by penile inversion or with a pedicled rectosigmoid flap), the surgeon will perform the so-called vaginal cosmetic surgery. This type of intervention consists of the design and construction of the labia minora, the clitoris and the clitoral hood that covers the latter.
BODY FEMINISATION SURGERY
THREE-DIMENSIONAL LIPOSCULPTURE
Hormonation achieves changes in the body of the female transsexual that bring her closer to the shapes of biological women but without achieving it completely. Fat accumulates differently in biological men and women. Three-dimensional liposculpture allows you to shape the body and give it the curves typical of its gender. Thus, with liposculpture, we eliminate those fat deposits located in specific areas of the body: chin, jowls, cheeks, arms, chest contours, abdomen, buttocks, hips, thighs, calves and ankles. The most common is waist liposculpture, which allows the curves of the transsexual woman to be shaped to resemble that of the biological woman.
BREAST AUGMENTATION OR ENLARGEMENT MAMMOPLASTY
Although hormones significantly help breast growth, in many cases this is not enough or is not what the patient desires. In these cases, a breast augmentation (augmentation mammaplasty) is recommended, which can be performed before vaginoplasty and which will help assume the feminine role. Augmentation mammoplasty or breast augmentation is the name given to surgery that allows, thanks to implants or prostheses, to enlarge the volume of the breasts, at the same time giving them an aesthetically feminine shape. Although there are different ways to place the implant - areola and breast fold - the most used is usually the armpit. The prostheses used are of the latest generation - made of high-quality cohesive silicone gel - and currently, the safest on the market.
ABDOMINOPLASTY OR DERMOLIPECTOMY
Transsexual women may have a certain tendency to accumulate fat in the abdominal area. This accumulation cannot be eliminated with a low-calorie diet or with physical exercise. Sometimes these fat deposits are accompanied by distension of the abdominal muscles, which further accentuates the feeling of a "sagging belly". Abdominoplasty or tummy tuck is the surgical technique used to remove excess skin and fat from the abdomen and to improve the silhouette (especially the waist). In addition, it also allows you to stretch the muscles of the abdominal wall.
INCREASING OF BUTTOCKS
It is indisputable that biological men and women have different gluteal areas in both shape and volume. Hormonation manages to give the transsexual woman curves more in line with her gender, but in some cases, the final shape of her buttocks does not quite satisfy her or does not meet her expectations. Plastic surgery offers the possibility of increasing the buttocks, giving them volume or remodelling the contour of the gluteal area in transsexual women who have it atrophied. This intervention is performed using implants, although, sometimes, it is also necessary to combine it with liposculpture and remodelling of the area, so that the result is optimal.
FACIAL FEMINISATION SURGERY
FEMINISING RHINOPLASTY
Rhinoplasty or nose reconstruction surgery is an intervention that allows you to increase or reduce the size of your nose, changing the configuration: the shape of the bridge or tip; the size of the nostrils or the angle between the nose and the upper lip. It is also used to correct birth defects or accidents as well as nasal breathing problems. Rhinoplasty is one of the most common interventions to feminise the face and currently allows us to create completely natural noses in line with the new harmony of the face. Thanks to this intervention, the features are softened, giving a more youthful image, with finer and more feminine features. This intervention can be performed both before and after vaginoplasty.
LARYNGEAL PROMINENCE OR THYROPLASTY
One of the most requested interventions by transsexual women, after vaginoplasty and breast augmentation, is the reduction of the Adam's apple or laryngeal prominence. The prominence of this cartilage is characteristic of biological men, so, in cases of exceptional prominence, it is advisable to perform this intervention before the life experience to adapt better. Although the choice of the type of anaesthesia will depend on the assessment of the surgeon and his medical team, the reduction of the Adam's apple or thyroplasty is performed, in most cases, with local anaesthesia plus sedation; and usually lasts about an hour.
CHEEK AUGMENTATION
Cheek augmentation is an intervention designed to increase, using a prosthesis, the size of the cheekbones to create greater harmony in both the face and the patient's profile. This operation is usually associated with rhinoplasty, mentoplasty, facelift or blepharoplasty. Cheek augmentation helps to soften the features while giving the patient's face a more sensual and feminine appearance. In addition, it helps highlight the patient's eyes and gaze. Cheek augmentation or malar implants is an intervention that may generally require local or local anaesthesia with sedation and the duration of the operation ranges between 30 and 45 minutes if it is not combined with other operations.
MENTOPLASTY AND FEMINISED FACIAL PROFILE
Mentoplasty is an intervention designed to increase or decrease the size of the chin to create greater harmony in both the face and the patient's profile. This operation is usually associated with rhinoplasty. Mentoplasty consists of implanting a prosthesis or sliding a fragment of bone forward to project the chin or reduce the jaw bone, depending on the results you wish to achieve. This intervention helps to soften the profile and highlight the mouth and lips. In addition, it helps give more feminine and balanced features to those patients who have a slightly prominent chin in relation to their nose and the rest of their face or reduce the chin to patients with a very prominent bone.
FEMINISING FACE LIFTING
One of the interventions that allow the face to be modelled, and therefore give it more feminine features, is undoubtedly the facelift or rhytidectomy. In addition, it also allows you to eliminate facial wrinkles, giving the face a young and clear appearance. Lifting or rhytidectomy is a procedure designed to lift and tighten the facial and cervical skin with the aim of reducing folds and wrinkles. In transsexual patients, this technique can also be used to reshape the face, giving it more feminine features.
VOICE FEMINISATION SURGERY
The feminisation of the voice is a process that aims to obtain a voice with the characteristics of a woman. Thus, the change in voice towards a more feminine one is obtained through surgery and speech therapy. It is, therefore, a multidisciplinary work of Otorhinolaryngology and Speech Therapy.
What is the voice feminization and how is it achieved?
Regarding voice feminisation surgery options, at barnaclínic+ we perform two types of intervention:
WENDLER GLOTTOPLASTY
Wendler Glottoplasty is a type of surgical technique for feminising the voice that consists of adjusting the shape of the larynx so that it can emit the voice in a more feminine way, tightening the vocal cords and shortening the length of the vibrating portion of them.
LASER-ASSISTED VOICE ADJUSTMENT (LAVA)
To achieve feminisation of the voice, a Wendler glottoplasty can be performed alone or it can be combined with another procedure called LAVA, for its acronym in English (Laser Assisted Voice Adjustment). The LAVA technique consists of vaporising the vocal folds with a laser to tighten the vibrating part of them, sharpening the voice even more.
HOW CAN WE HELP TRANS MEN?
CHEST MASCULINISATION
Masculinising chest surgery is the surgical technique through which the glandular breast tissue is removed. This intervention aims to achieve a smooth and symmetrical chest that is anatomically and aesthetically masculine.
HYSTERECTOMY AND ANNEXECTOMY
Hysterectomy and adnexectomy is the surgical technique through which the womb and ovaries are removed. This intervention aims to avoid the effect of female hormones produced by the ovaries, as well as possible diseases that may settle in the internal female genitalia, which seem to be enhanced by the consumption of male hormones. In addition, it is the basis for subsequent gender confirmation surgery.
If you are already clear that you want to undergo gender affirmation treatment or if you simply want to contact our team of experts at the Gender Identity Unit, you can do so through the following link. Write to us, explain your case and we will advise on the best option.
WE ACCOMPANY YOU THROUGHOUT THE PROCESS
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A patient manager will receive your request and will contact you in your language within 24 hours.
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You will speak by video conference with your surgeon or the team that will perform your operation.
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We will plan with you the treatment plan, the trip and the stay in Barcelona.
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We will organise the trip in the most comfortable way for you, we will offer you accommodation options near the hospital, in the centre of Barcelona.
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Throughout the whole process, our team will be at your disposal to accompany you and answer any questions you may have in your language.
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After the intervention, we will remain at your disposal and will follow up regularly.
Receive your treatment plan within 48h
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TRANSGENDER BLOG
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