Gender Reassessment

Since ancient times there was as a phenomenon persons to feel differently than their genetically determined sex. In many ancient texts one can find cases, mostly of men who behaved with effeminacy, dressing accordingly, and also living together with their lover. Also in indigenous tribes of South America are mentioned even homosexuals marriages. In Ancient Rome the eunuchs were known with effeminate behavior, which surrounded the Empress. The treatment of such persons by the society was always cautious, sometimes tolerant and sometimes very hostile. In the early 20th century, the tendency of these people was considered as mental illness which did not get any treatment. There were many incidents forcibly subjected to electric shocks. Since the beginning of the century until today, people with such behavior, with soul in pain in India abandoned their families to join in caste, known as Hijra in order to undergo mutilation of their genital organs. This “third” sex showed no vagina but at least showed a female body type which resulted from the disappearance of male hormones. With the evolution of societies, their gradual emancipation of the pietistic commitments and the progress of science became clearer that this phenomenon is not a mental illness or misfortune, but an endogenous tendency of these individuals, who if corrected their gender they would happier. Doctor Harry Benjamin, MD in America, only in the mid 50 treated these persons with different perceptions and granted estrogen helping them to develop a more feminine image of their body. At the same time, the American resident Christine Jorgensen had her gender corrected publishing her story causing great national sense.

The actual surgical techniques for correcting the gender began to develop at that time. The French surgeon Georges Burou is known, MD in the late 50”s when he operated thousands of patients around the world in his clinic in Casablanca, Morocco. This technique that uses the skin of the male molecule to create the vagina takes even currently a place in surgery.

Ongoing developments of these techniques are developed and any surgeon who dealt with this surgical adds benefits using the knowledge of plastics. The goal is the best cosmetic result, the excellent functional capacity of the new vagina, the erectile and unorgasmic function but also the shortness of the surgery and the postoperative course. Ongoing developments of these techniques are developed and any surgeon who dealt with the surgical adds benefits using their knowledge of plastic. The goal is the best cosmetic result, the excellent functional capacity of the newly vagina, the erectile function and unorgasmic but also the shortness of surgery and the postoperative course. Today, with the improved technique of Georges Burou, MD the procedure takes only 2.5 hours, and the patient does not need to stay more than one day in hospital. The problems that occurred in the past with the narrowing of the new vagina do no longer appear as the skin of the penis is used as a vascularized flap where there is no shrinkage. Also the maintaining of its innervation offers sentience to the new vagina, which in combination with its proximity to the rectum and the vagina neural plexus is offering the ultimate orgasm. The orgasm is assisted by the pulse of the erectile tissue of the prostate gland, which is maintained as well as a small part of erectile tissue, which also is retained to create new clitoris. The stay of the patient in hospital is not required over the first postoperative day, and sexual intercourse is not prohibited for more than the month.

1. The psychiatric diagnosis is required.
2. The operation lasts 2,5-3 hours.
3. The hospitalization is required for 1-2 days.
4. The operation is almost painless, however if there is pain for a few days it is managed with simple painkillers.
5. The surgery consists of testes excision and reversal of the skin flap of the penis, keeping the glans, simulating the cervix, in a space between the rectum and the prostate.
6. The new technique except of the simulation of the cervical achieves the creation of small and labia majora.
7. The aesthetic effect is almost immediate and natural.
8. A urinary catheter is kept for 15 days. It must be maintained during this time to prevent shrinkage of the orifice of the urethra.
9. Daily cleaning with betadin rinses and showers are necessary immediately after leaving the clinic.
10. After 15 days the use of dummy penis is necessary to maintain the depth and width of the vagina.
11. Sexual contact is allowed, as well as encouraged after a month.
12. Vaginal orgasm is referred by the majority of patients.
13. The hormone therapy, if there was any, is to be distinguished as with the testes excision the androgenic hormones (testosterone) almost disappear. A contact with an endocrinologist and a hormone therapy can be initiated afterwards.
14. The estrogen, which many may receive, is useful to get stopped one week before the surgery, while preventive anticoagulant therapy with low molecular weight heparin, a few days ago, reduce the likelihood of thrombosis in the veins.