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Gender Surgeons in United States

Learn about Surgeons in the U.S. who offer Male to Female (MTF) and Female to Male (FTM) procedures, also known as Gender Confirmation Surgery (GCS), Sex Reassignment Surgery (SRS) or Gender Reassignment Surgery (GRS).

Dr. Charles Garramone

Dr. Garramone is one of the most experienced Top Surgery surgeons in the world, having performed thousands of Top Surgery procedures since 2005. With Dr. Garramone, you won’t have to worry about what your Top Surgery results will look like. His FTM Top Surgery technique is sought after by thousands of patients for its consistent and predictable results.

Dr. Scott Mosser

Dr. Mosser is an award-winning surgeon in San Francisco who has been helping transgender and non-binary patients for more than 10 years. He is board-certified by the American Board of Plastic Surgeons, co-founder of the American Society of Gender Surgeons (ASGS), Medical Director of the Gender Institute at Saint Francis Memorial Hospital, a member of WPATH, and co-chair of the Surgery and Beyond professional conference. Dr. Mosser is California’s FTN / FTM Top Surgery and Breast Augmentation expert.

Dr. Drew Schnitt

Dr. Schnitt is a board certified cosmetic, plastic, reconstructive and craniofacial surgeon who has been practicing in South Florida since 2002. His experience in cosmetic and craniofacial surgery makes him an excellent choice for gender-affirming facial surgery, as well as Top Surgery, Breast Augmentation and Body Sculpting.

Dr. Daniel Crane

Dr. Crane is a plastic surgeon who joined Dr. Drew Schnitt’s Inspire Aesthetics in 2022, expanding access to gender-affirming surgical care in South Florida. After completing a highly specialized aesthetic surgery fellowship where he performed countless breast, body contouring and facial surgeries, Dr. Crane worked with Dr. Schnitt to refine his skills with Top Surgery and Facial Feminization. His broad training in plastic and aesthetic surgery provides him with the knowledge and experience to help you achieve your transition goals.

Dr. Daniel Jacobs

Dr. Jacobs is an award-winning and board-certified plastic surgeon in San Francisco who joined The Gender Confirmation Center in July, 2022. Dr. Jacobs has more than 30 years of plastic surgery experience and provides outstanding surgical care for transmasculine, transfeminine and non-binary patients.

Dr. Josef Hadeed

Dr. Hadeed is a board-certified surgeon who specializes in Transgender Surgery, including chest/breast procedures, facial surgeries and body sculpting for both trans men and women. Dr. Hadeed’s practice now has two locations: Beverly Hills, California and Miami, Florida.

Dr. Michelle Lee

Dr. Lee is a fellowship-trained and board-certified plastic surgeon with deep expertise in aesthetic and reconstructive procedures for the chest/breast and face. Based in Beverly Hills, California, Dr. Lee is as well-known for her surgical precision as she is for the compassion, care and understanding that she has for all of her patients. She has the skill and artistry to help produce the aesthetic goals that transgender and non-binary patients seek with Top Surgery, Breast Augmentation and Facial Gender Confirmation Surgery.

Dr. Russell Sassani

Dr. Sassani is a board certified plastic and reconstructive surgeon who performs chest procedures, facial surgeries and body sculpting for both trans men and women in Florida. With unanimous 5 star reviews from his trans male patients, Dr. Sassani has quickly become one of the most popular Top Surgery surgeons in the Southeastern United States.

Dr. Angela Rodriguez

Dr. Rodriguez is a board-certified plastic surgeon in San Francisco who is dedicated full time to providing surgical care for transgender patients. Dr. Rodriguez had 14 years of craniofacial, aesthetic and pediatric plastic surgery experience before becoming a Gender Surgeon. She has a special interest in Facial Feminization and is also highly proficient in Vaginoplasty and Top Surgery.

Dr. Daniel J. Freet

Dr. Freet leads a multidisciplinary team at the University of Texas that performs both male-to-female and female-to-male surgery procedures, including facial and chest surgeries as well as Vaginoplasty, Metoidioplasty and Phalloplasty. Dr. Freet accepts both insurance and Medicare.

Dr. Alvina Won

Dr. Won is a board-certified surgeon who is committed to providing the highest quality of care in a welcoming environment for all patients. Dr. Won gained significant experience with gender-affirming surgery during a year-long cosmetic surgery fellowship. Finding this work to be extremely gratifying and interesting, Dr. Won now devotes part of her practice to serving the transgender patient population. Based in Washington state, just north of Seattle, she offers Top Surgery, Breast and Buttock Augmentation, and Body Sculpting.

Dr. Gabriel Del Corral

Dr. Del Corral is a double board-certified plastic and reconstructive surgeon who offers Gender Affirmation Surgery at the MedStar Center for Gender Affirmation in Washington D.C. and Baltimore, Maryland. He is an Assistant Professor of Plastic Surgery at Medstar Georgetown University Hospital. Dr. Del Corral is fellowship trained in microsurgery, and has expertise in reconstructive surgery, maxillofacial surgery and cosmetic surgery. He specializes in gender-affirming procedures with a special focus on Vaginoplasty, Facial Feminization and Phalloplasty.

Dr. Praful Ramineni

Dr. Ramineni is a board-certified plastic and reconstructive surgeon with over 15 years of experience. Based in Washington, D.C., Dr. Ramineni performs upwards of 600 surgeries a year and has a specialization in Gender Affirmation Surgery. Recognized for his exceptional surgical skills and natural-looking results, Dr. Ramineni’s patients also praise his friendly, compassionate and professional nature.

Dr. Cassie Nghiem

Dr. Nghiem is an Ivy League-educated, fellowship-trained plastic surgeon in Washington, D.C. who specializes in transgender surgery, including Chest Masculinization and Breast Augmentation. She believes in a shared vision and works closely with her patients to deliver the best quality care that is in line with their needs. Known for her surgical skill and artistry, Dr. Nghiem’s patients also love her kind and caring demeanor.

Dr. Curtis Crane

Dr. Crane is a board-certified plastic surgeon who performs Gender Affirming Surgery procedures in Austin, Texas. Dr. Crane is one of only a few surgeons in the world who is trained as both a plastic surgeon and urologist and has also completed fellowships in reconstructive urology and gender reassignment surgery. He has been performing gender surgery since 2005.

Dr. Dany Hanna

Dr. Hanna is a Urologist and fellowship-trained Gender Surgeon who works exclusively with transgender and non-binary patients at the Hanna Gender Center in Dallas, Texas. He completed a yearlong fellowship in gender-affirming surgery and also trained with the renowned Dr. Miroslav Djordjevic in Belgrade, Serbia. Dr. Hanna specializes in Vaginoplasty and also offers Nullification, Metoidioplasty, Top Surgery and Breast Augmentation.

Dr. Thomas Satterwhite

Dr. Satterwhite is a board-certified Plastic and Craniofacial Surgeon in San Francisco who is dedicated to offering the highest level of surgical care to the transgender community. Dr. Satterwhite works exclusively with trans women, trans men and non-binary patients seeking Gender Confirmation procedures such as Vaginoplasty, Facial Feminization, and FTM Top Surgery.

Dr. Dev Gurjala

Dr. Gurjala joined Align Surgical Associates in 2019, after five years of performing gender surgery, microsurgery, and general reconstructive and aesthetic surgery in the Kaiser Permanente healthcare network. He works exclusively with trans women, trans men and non-binary patients seeking gender-affirming surgeries, including Phalloplasty, Vaginoplasty and Facial Feminization.

Dr. Lorelei Grunwaldt

Dr. Grunwaldt is a double board-certified plastic surgeon who is recognized as one of the best plastic surgeons in the Pittsburgh area due to her exceptional skills and compassionate bedside manner. Dr. Grunwaldt has helped countless transgender and non-binary adults and teens by providing a safe and caring atmosphere throughout their Top Surgery and Breast Augmentation journeys. She is honored to be able to share her surgical talents and be a trusted member of her patients’ transition team.

Dr. Michael Safir

Dr. Safir is a board-certified urologist in Los Angeles who specializes exclusively in gender-affirming bottom surgery procedures. With subspecialty certification in Female Pelvic Medicine and Reconstructive Surgery, Dr. Safir is one of a handful of urologists in the world with individual fellowship training and experience in both male and female genital reconstruction. He gained extensive experience over five years performing genital surgeries at one of the highest volume gender surgery centers in the world and is now affiliated with Align Surgical Associates out of Los Angeles. Dr. Safir’s vast experience in urology has made him a popular choice among transgender people from across the U.S. seeking bottom surgery.

Dr. John Henry Pang

Dr. Pang is a double board-certified plastic and reconstructive surgeon who performs gender-affirming genital, face and chest reconstruction surgeries. In 2019, Dr. Pang completed the intensive Transgender Surgery Fellowship training program at Mount Sinai. Now an associate surgeon at Align Surgical in San Francisco, Dr. Pang’s practice is dedicated to providing specialized care to the transgender and gender-nonconforming communities.

Dr. Drew Marano

Dr. Marano is a highly skilled plastic and reconstructive surgeon in New York City specializing in Gender Affirmation Surgery. Dr. Marano is fellowship-trained in gender-affirming facial, chest and genital surgeries, including Phalloplasty and Vaginoplasty. He is passionate about gender-affirming care and committed to providing a comfortable and supportive environment for his patients.

Dr. Paul Steinwald

Dr. Steinwald has performed FTM Top Surgery hundreds of times, and he’s well-known for having pioneered the Inverted-T procedure. Dr. Steinwald has the most experience with Top Surgery than any other surgeon in Colorado. Body Feminization and Breast Augmentation are also offered for trans feminine folks.

Dr. Kenan Celtik

Dr. Celtik is a Reconstructive Urologist who has dedicated his practice to gender-affirming genital surgery. He is fellowship-trained in Gender Surgery and has received 15 years of advanced education from some of the most highly regarded academic hospitals in the United States. With his elite training, deep expertise in complex genitourinary reconstruction, and a strong commitment to excellence, Dr. Celtik is uniquely positioned as a Gender Surgeon.

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What Is Gender Affirmation Surgery?

A gender affirmation surgery allows individuals, such as those who identify as transgender or nonbinary, to change one or more of their sex characteristics. This type of procedure offers a person the opportunity to have features that align with their gender identity.

For example, this type of surgery may be a transgender surgery like a male-to-female or female-to-male surgery. Read on to learn more about what masculinizing, feminizing, and gender-nullification surgeries may involve, including potential risks and complications.

Why Is Gender Affirmation Surgery Performed?

A person may have gender affirmation surgery for different reasons. They may choose to have the surgery so their physical features and functional ability align more closely with their gender identity.

For example, one study found that 48,019 people underwent gender affirmation surgeries between 2016 and 2020. Most procedures were breast- and chest-related, while the remaining procedures concerned genital reconstruction or facial and cosmetic procedures.

In some cases, surgery may be medically necessary to treat dysphoria. Dysphoria refers to the distress that transgender people may experience when their gender identity doesn't match their sex assigned at birth. One study found that people with gender dysphoria who had gender affirmation surgeries experienced:

• Decreased antidepressant use
• Decreased anxiety, depression, and suicidal ideation
• Decreased alcohol and drug abuse

However, these surgeries are only performed if appropriate for a person's case. The appropriateness comes about as a result of consultations with mental health professionals and healthcare providers.

Transgender vs Nonbinary

Transgender and nonbinary people can get gender affirmation surgeries. However, there are some key ways that these gender identities differ.

Transgender is a term that refers to people who have gender identities that aren't the same as their assigned sex at birth. Identifying as nonbinary means that a person doesn't identify only as a man or a woman. A nonbinary individual may consider themselves to be:

• Both a man and a woman
• Neither a man nor a woman
• An identity between or beyond a man or a woman

Hormone Therapy

Gender-affirming hormone therapy uses sex hormones and hormone blockers to help align the person's physical appearance with their gender identity. For example, some people may take masculinizing hormones.

"They start growing hair, their voice deepens, they get more muscle mass," Heidi Wittenberg, MD , medical director of the Gender Institute at Saint Francis Memorial Hospital in San Francisco and director of MoZaic Care Inc., which specializes in gender-related genital, urinary, and pelvic surgeries, told Health .

Types of hormone therapy include:

• Masculinizing hormone therapy uses testosterone. This helps to suppress the menstrual cycle, grow facial and body hair, increase muscle mass, and promote other male secondary sex characteristics.
• Feminizing hormone therapy includes estrogens and testosterone blockers. These medications promote breast growth, slow the growth of body and facial hair, increase body fat, shrink the testicles, and decrease erectile function.
• Non-binary hormone therapy is typically tailored to the individual and may include female or male sex hormones and/or hormone blockers.

It can include oral or topical medications, injections, a patch you wear on your skin, or a drug implant. The therapy is also typically recommended before gender affirmation surgery unless hormone therapy is medically contraindicated or not desired by the individual.

Masculinizing Surgeries

Masculinizing surgeries can include top surgery, bottom surgery, or both. Common trans male surgeries include:

• Chest masculinization (breast tissue removal and areola and nipple repositioning/reshaping)
• Hysterectomy (uterus removal)
• Metoidioplasty (lengthening the clitoris and possibly extending the urethra)
• Oophorectomy (ovary removal)
• Phalloplasty (surgery to create a penis)
• Scrotoplasty (surgery to create a scrotum)

Top Surgery

Chest masculinization surgery, or top surgery, often involves removing breast tissue and reshaping the areola and nipple. There are two main types of chest masculinization surgeries:

• Double-incision approach : Used to remove moderate to large amounts of breast tissue, this surgery involves two horizontal incisions below the breast to remove breast tissue and accentuate the contours of pectoral muscles. The nipples and areolas are removed and, in many cases, resized, reshaped, and replaced.
• Short scar top surgery : For people with smaller breasts and firm skin, the procedure involves a small incision along the lower half of the areola to remove breast tissue. The nipple and areola may be resized before closing the incision.

Metoidioplasty

Some trans men elect to do metoidioplasty, also called a meta, which involves lengthening the clitoris to create a small penis. Both a penis and a clitoris are made of the same type of tissue and experience similar sensations.

Before metoidioplasty, testosterone therapy may be used to enlarge the clitoris. The procedure can be completed in one surgery, which may also include:

• Constructing a glans (head) to look more like a penis
• Extending the urethra (the tube urine passes through), which allows the person to urinate while standing
• Creating a scrotum (scrotoplasty) from labia majora tissue

Phalloplasty

Other trans men opt for phalloplasty to give them a phallic structure (penis) with sensation. Phalloplasty typically requires several procedures but results in a larger penis than metoidioplasty.

The first and most challenging step is to harvest tissue from another part of the body, often the forearm or back, along with an artery and vein or two, to create the phallus, Nicholas Kim, MD, assistant professor in the division of plastic and reconstructive surgery in the department of surgery at the University of Minnesota Medical School in Minneapolis, told Health .

Those structures are reconnected under an operative microscope using very fine sutures—"thinner than our hair," said Dr. Kim. That surgery alone can take six to eight hours, he added.

In a separate operation, called urethral reconstruction, the surgeons connect the urinary system to the new structure so that urine can pass through it, said Dr. Kim. Urethral reconstruction, however, has a high rate of complications, which include fistulas or strictures.

According to Dr. Kim, some trans men prefer to skip that step, especially if standing to urinate is not a priority. People who want to have penetrative sex will also need prosthesis implant surgery.

Hysterectomy and Oophorectomy

Masculinizing surgery often includes the removal of the uterus (hysterectomy) and ovaries (oophorectomy). People may want a hysterectomy to address their dysphoria, said Dr. Wittenberg, and it may be necessary if their gender-affirming surgery involves removing the vagina.

Many also opt for an oophorectomy to remove the ovaries, almond-shaped organs on either side of the uterus that contain eggs and produce female sex hormones. In this case, oocytes (eggs) can be extracted and stored for a future surrogate pregnancy, if desired. However, this is a highly personal decision, and some trans men choose to keep their uterus to preserve fertility.

Feminizing Surgeries

Surgeries are often used to feminize facial features, enhance breast size and shape, reduce the size of an Adam’s apple , and reconstruct genitals.  Feminizing surgeries can include: 

• Breast augmentation
• Facial feminization surgery
• Penis removal (penectomy)
• Scrotum removal (scrotectomy)
• Testicle removal (orchiectomy)
• Tracheal shave (chondrolaryngoplasty) to reduce an Adam's apple
• Vaginoplasty
• Voice feminization

Breast Augmentation

Top surgery, also known as breast augmentation or breast mammoplasty, is often used to increase breast size for a more feminine appearance. The procedure can involve placing breast implants, tissue expanders, or fat from other parts of the body under the chest tissue.

Breast augmentation can significantly improve gender dysphoria. Studies show most people who undergo top surgery are happier, more satisfied with their chest, and would undergo the surgery again.

Most surgeons recommend 12 months of feminizing hormone therapy before breast augmentation. Since hormone therapy itself can lead to breast tissue development, transgender women may or may not decide to have surgical breast augmentation.

Facial Feminization and Adam's Apple Removal

Facial feminization surgery (FFS) is a series of plastic surgery procedures that reshape the forehead, hairline, eyebrows, nose, cheeks, and jawline. Nonsurgical treatments like cosmetic fillers, botox, fat grafting, and liposuction may also be used to create a more feminine appearance.  

Some trans women opt for chondrolaryngoplasty, also known as a tracheal shave. The procedure reduces the size of the Adam's apple, an area of cartilage around the larynx (voice box) that tends to be larger in people assigned male at birth.

Vulvoplasty and Vaginoplasty

As for bottom surgery, there are various feminizing procedures from which to choose. Vulvoplasty (to create external genitalia without a vagina) or vaginoplasty (to create a vulva and vaginal canal) are two of the most common procedures.

Dr. Wittenberg noted that people might undergo six to 12 months of electrolysis or laser hair removal before surgery to remove pubic hair from the skin that will be used for the vaginal lining.

Surgeons have different techniques for creating a vaginal canal. A common one is a penile inversion, where the masculine structures are emptied and inverted into a created cavity, explained Dr. Kim. Vaginoplasty may be done in one or two stages, said Dr. Wittenberg, and the initial recovery is three months—but it will be a full year until people see results.

Surgical removal of the penis or penectomy is sometimes used in feminization treatment. This can be performed along with an orchiectomy and scrotectomy.

However, a total penectomy is not commonly used in feminizing surgeries . Instead, many people opt for penile-inversion surgery, a technique that hollows out the penis and repurposes the tissue to create a vagina during vaginoplasty.

Orchiectomy and Scrotectomy

An orchiectomy is a surgery to remove the testicles —male reproductive organs that produce sperm. Scrotectomy is surgery to remove the scrotum, that sac just below the penis that holds the testicles.

However, some people opt to retain the scrotum. Scrotum skin can be used in vulvoplasty or vaginoplasty, surgeries to construct a vulva or vagina.

Other Surgical Options

Some gender non-conforming people opt for other types of surgeries. This can include:

• Gender nullification procedures
• Penile preservation vaginoplasty
• Vaginal preservation phalloplasty

Gender Nullification

People who are agender or asexual may opt for gender nullification, sometimes called nullo. This involves the removal of all sex organs. The external genitalia is removed, leaving an opening for urine to pass and creating a smooth transition from the abdomen to the groin.

Depending on the person's sex assigned at birth, nullification surgeries can include:

• Breast tissue removal
• Nipple and areola augmentation or removal

Penile Preservation Vaginoplasty

Some gender non-conforming people assigned male at birth want a vagina but also want to preserve their penis, said Dr. Wittenberg. Often, that involves taking skin from the lining of the abdomen to create a vagina with full depth.

Vaginal Preservation Phalloplasty

Alternatively, a patient assigned female at birth can undergo phalloplasty (surgery to create a penis) and retain the vaginal opening. Known as vaginal preservation phalloplasty, it is often used as a way to resolve gender dysphoria while retaining fertility.

The recovery time for a gender affirmation surgery will depend on the type of surgery performed. For example, healing for facial surgeries may last for weeks, while transmasculine bottom surgery healing may take months.

Your recovery process may also include additional treatments or therapies. Mental health support and pelvic floor physiotherapy are a few options that may be needed or desired during recovery.

Risks and Complications

The risk and complications of gender affirmation surgeries will vary depending on which surgeries you have. Common risks across procedures could include:

• Anesthesia risks
• Hematoma, which is bad bruising
• Poor incision healing

Complications from these procedures may be:

• Acute kidney injury
• Blood transfusion
• Deep vein thrombosis, which is blood clot formation
• Pulmonary embolism, blood vessel blockage for vessels going to the lung
• Rectovaginal fistula, which is a connection between two body parts—in this case, the rectum and vagina
• Surgical site infection
• Urethral stricture or stenosis, which is when the urethra narrows
• Urinary tract infection (UTI)
• Wound disruption

What To Consider

It's important to note that an individual does not need surgery to transition. If the person has surgery, it is usually only one part of the transition process.

There's also psychotherapy . People may find it helpful to work through the negative mental health effects of dysphoria. Typically, people seeking gender affirmation surgery must be evaluated by a qualified mental health professional to obtain a referral.

Some people may find that living in their preferred gender is all that's needed to ease their dysphoria. Doing so for one full year prior is a prerequisite for many surgeries.

All in all, the entire transition process—living as your identified gender, obtaining mental health referrals, getting insurance approvals, taking hormones, going through hair removal, and having various surgeries—can take years, healthcare providers explained.

A Quick Review

Whether you're in the process of transitioning or supporting someone who is, it's important to be informed about gender affirmation surgeries. Gender affirmation procedures often involve multiple surgeries, which can be masculinizing, feminizing, or gender-nullifying in nature.

It is a highly personalized process that looks different for each person and can often take several months or years. The procedures also vary regarding risks and complications, so consultations with healthcare providers and mental health professionals are essential before having these procedures.

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Preparation and Procedures Involved in Gender Affirmation Surgeries

If you or a loved one are considering gender affirmation surgery , you are probably wondering what steps you must go through before the surgery can be done. Let's look at what is required to be a candidate for these surgeries, the potential positive effects and side effects of hormonal therapy, and the types of surgeries that are available.

Gender affirmation surgery, also known as gender confirmation surgery, is performed to align or transition individuals with gender dysphoria to their true gender.

A transgender woman, man, or non-binary person may choose to undergo gender affirmation surgery.

The term "transexual" was previously used by the medical community to describe people who undergo gender affirmation surgery. The term is no longer accepted by many members of the trans community as it is often weaponized as a slur. While some trans people do identify as "transexual", it is best to use the term "transgender" to describe members of this community.

Transitioning

Transitioning may involve:

• Social transitioning : going by different pronouns, changing one’s style, adopting a new name, etc., to affirm one’s gender
• Medical transitioning : taking hormones and/or surgically removing or modifying genitals and reproductive organs

Transgender individuals do not need to undergo medical intervention to have valid identities.  

Reasons for Undergoing Surgery

Many transgender people experience a marked incongruence between their gender and their assigned sex at birth.   The American Psychiatric Association (APA) has identified this as gender dysphoria.

Gender dysphoria is the distress some trans people feel when their appearance does not reflect their gender. Dysphoria can be the cause of poor mental health or trigger mental illness in transgender people.

For these individuals, social transitioning, hormone therapy, and gender confirmation surgery permit their outside appearance to match their true gender.  

Steps Required Before Surgery

In addition to a comprehensive understanding of the procedures, hormones, and other risks involved in gender-affirming surgery, there are other steps that must be accomplished before surgery is performed. These steps are one way the medical community and insurance companies limit access to gender affirmative procedures.

Steps may include:

• Mental health evaluation : A mental health evaluation is required to look for any mental health concerns that could influence an individual’s mental state, and to assess a person’s readiness to undergo the physical and emotional stresses of the transition.  
• Clear and consistent documentation of gender dysphoria
• A "real life" test :   The individual must take on the role of their gender in everyday activities, both socially and professionally (known as “real-life experience” or “real-life test”).

Firstly, not all transgender experience physical body dysphoria. The “real life” test is also very dangerous to execute, as trans people have to make themselves vulnerable in public to be considered for affirmative procedures. When a trans person does not pass (easily identified as their gender), they can be clocked (found out to be transgender), putting them at risk for violence and discrimination.

Requiring trans people to conduct a “real-life” test despite the ongoing violence out transgender people face is extremely dangerous, especially because some transgender people only want surgery to lower their risk of experiencing transphobic violence.

Hormone Therapy & Transitioning

Hormone therapy involves taking progesterone, estrogen, or testosterone. An individual has to have undergone hormone therapy for a year before having gender affirmation surgery.  

The purpose of hormone therapy is to change the physical appearance to reflect gender identity.

Effects of Testosterone

When a trans person begins taking testosterone , changes include both a reduction in assigned female sexual characteristics and an increase in assigned male sexual characteristics.

Bodily changes can include:

• Beard and mustache growth  
• Deepening of the voice
• Enlargement of the clitoris  
• Increased growth of body hair
• Increased muscle mass and strength  
• Increase in the number of red blood cells
• Redistribution of fat from the breasts, hips, and thighs to the abdominal area  
• Development of acne, similar to male puberty
• Baldness or localized hair loss, especially at the temples and crown of the head  
• Atrophy of the uterus and ovaries, resulting in an inability to have children

Behavioral changes include:

• Aggression  
• Increased sex drive

Effects of Estrogen

When a trans person begins taking estrogen , changes include both a reduction in assigned male sexual characteristics and an increase in assigned female characteristics.

Changes to the body can include:

• Breast development  
• Loss of erection
• Shrinkage of testicles  
• Decreased acne
• Decreased facial and body hair
• Decreased muscle mass and strength  
• Softer and smoother skin
• Slowing of balding
• Redistribution of fat from abdomen to the hips, thighs, and buttocks  
• Decreased sex drive
• Mood swings  

When Are the Hormonal Therapy Effects Noticed?

The feminizing effects of estrogen and the masculinizing effects of testosterone may appear after the first couple of doses, although it may be several years before a person is satisfied with their transition.   This is especially true for breast development.

Timeline of Surgical Process

Surgery is delayed until at least one year after the start of hormone therapy and at least two years after a mental health evaluation. Once the surgical procedures begin, the amount of time until completion is variable depending on the number of procedures desired, recovery time, and more.

Transfeminine Surgeries

Transfeminine is an umbrella term inclusive of trans women and non-binary trans people who were assigned male at birth.

Most often, surgeries involved in gender affirmation surgery are broken down into those that occur above the belt (top surgery) and those below the belt (bottom surgery). Not everyone undergoes all of these surgeries, but procedures that may be considered for transfeminine individuals are listed below.

Top surgery includes:

• Breast augmentation  
• Facial feminization
• Nose surgery: Rhinoplasty may be done to narrow the nose and refine the tip.
• Eyebrows: A brow lift may be done to feminize the curvature and position of the eyebrows.  
• Jaw surgery: The jaw bone may be shaved down.
• Chin reduction: Chin reduction may be performed to soften the chin's angles.
• Cheekbones: Cheekbones may be enhanced, often via collagen injections as well as other plastic surgery techniques.  
• Lips: A lip lift may be done.
• Alteration to hairline  
• Male pattern hair removal
• Reduction of Adam’s apple  
• Voice change surgery

Bottom surgery includes:

• Removal of the penis (penectomy) and scrotum (orchiectomy)  
• Creation of a vagina and labia

Transmasculine Surgeries

Transmasculine is an umbrella term inclusive of trans men and non-binary trans people who were assigned female at birth.

Surgery for this group involves top surgery and bottom surgery as well.

Top surgery includes :

• Subcutaneous mastectomy/breast reduction surgery.
• Removal of the uterus and ovaries
• Creation of a penis and scrotum either through metoidioplasty and/or phalloplasty

Complications and Side Effects

Surgery is not without potential risks and complications. Estrogen therapy has been associated with an elevated risk of blood clots ( deep vein thrombosis and pulmonary emboli ) for transfeminine people.   There is also the potential of increased risk of breast cancer (even without hormones, breast cancer may develop).

Testosterone use in transmasculine people has been associated with an increase in blood pressure, insulin resistance, and lipid abnormalities, though it's not certain exactly what role these changes play in the development of heart disease.  

With surgery, there are surgical risks such as bleeding and infection, as well as side effects of anesthesia . Those who are considering these treatments should have a careful discussion with their doctor about potential risks related to hormone therapy as well as the surgeries.  

Cost of Gender Confirmation Surgery

Surgery can be prohibitively expensive for many transgender individuals. Costs including counseling, hormones, electrolysis, and operations can amount to well over $100,000. Transfeminine procedures tend to be more expensive than transmasculine ones. Health insurance sometimes covers a portion of the expenses.

Quality of Life After Surgery

Quality of life appears to improve after gender-affirming surgery for all trans people who medically transition. One 2017 study found that surgical satisfaction ranged from 94% to 100%.  

Since there are many steps and sometimes uncomfortable surgeries involved, this number supports the benefits of surgery for those who feel it is their best choice.

A Word From Verywell

Gender affirmation surgery is a lengthy process that begins with counseling and a mental health evaluation to determine if a person can be diagnosed with gender dysphoria.

After this is complete, hormonal treatment is begun with testosterone for transmasculine individuals and estrogen for transfeminine people. Some of the physical and behavioral changes associated with hormonal treatment are listed above.

After hormone therapy has been continued for at least one year, a number of surgical procedures may be considered. These are broken down into "top" procedures and "bottom" procedures.

Surgery is costly, but precise estimates are difficult due to many variables. Finding a surgeon who focuses solely on gender confirmation surgery and has performed many of these procedures is a plus.   Speaking to a surgeon's past patients can be a helpful way to gain insight on the physician's practices as well.

For those who follow through with these preparation steps, hormone treatment, and surgeries, studies show quality of life appears to improve. Many people who undergo these procedures express satisfaction with their results.

Bizic MR, Jeftovic M, Pusica S, et al. Gender dysphoria: Bioethical aspects of medical treatment . Biomed Res Int . 2018;2018:9652305. doi:10.1155/2018/9652305

American Psychiatric Association. What is gender dysphoria? . 2016.

The World Professional Association for Transgender Health. Standards of care for the health of transsexual, transgender, and gender-nonconforming people . 2012.

Tomlins L. Prescribing for transgender patients . Aust Prescr . 2019;42(1): 10–13.  doi:10.18773/austprescr.2019.003

T'sjoen G, Arcelus J, Gooren L, Klink DT, Tangpricha V. Endocrinology of transgender medicine . Endocr Rev . 2019;40(1):97-117. doi:10.1210/er.2018-00011

Unger CA. Hormone therapy for transgender patients . Transl Androl Urol . 2016;5(6):877-884.  doi:10.21037/tau.2016.09.04

Seal LJ. A review of the physical and metabolic effects of cross-sex hormonal therapy in the treatment of gender dysphoria . Ann Clin Biochem . 2016;53(Pt 1):10-20.  doi:10.1177/0004563215587763

Schechter LS. Gender confirmation surgery: An update for the primary care provider . Transgend Health . 2016;1(1):32-40. doi:10.1089/trgh.2015.0006

Altman K. Facial feminization surgery: current state of the art . Int J Oral Maxillofac Surg . 2012;41(8):885-94.  doi:10.1016/j.ijom.2012.04.024

Therattil PJ, Hazim NY, Cohen WA, Keith JD. Esthetic reduction of the thyroid cartilage: A systematic review of chondrolaryngoplasty . JPRAS Open. 2019;22:27-32. doi:10.1016/j.jpra.2019.07.002

Top H, Balta S. Transsexual mastectomy: Selection of appropriate technique according to breast characteristics . Balkan Med J . 2017;34(2):147-155. doi:10.4274/balkanmedj.2016.0093

Chan W, Drummond A, Kelly M. Deep vein thrombosis in a transgender woman . CMAJ . 2017;189(13):E502-E504.  doi:10.1503/cmaj.160408

Streed CG, Harfouch O, Marvel F, Blumenthal RS, Martin SS, Mukherjee M. Cardiovascular disease among transgender adults receiving hormone therapy: A narrative review . Ann Intern Med . 2017;167(4):256-267. doi:10.7326/M17-0577

Hashemi L, Weinreb J, Weimer AK, Weiss RL. Transgender care in the primary care setting: A review of guidelines and literature . Fed Pract . 2018;35(7):30-37.

Van de grift TC, Elaut E, Cerwenka SC, Cohen-kettenis PT, Kreukels BPC. Surgical satisfaction, quality of life, and their association after gender-affirming aurgery: A follow-up atudy . J Sex Marital Ther . 2018;44(2):138-148. doi:10.1080/0092623X.2017.1326190

American Society of Plastic Surgeons. Gender confirmation surgeries .

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Colebunders B, Brondeel S, D'Arpa S, Hoebeke P, Monstrey S. An update on the surgical treatment for transgender patients . Sex Med Rev . 2017 Jan;5(1):103-109. doi:10.1016/j.sxmr.2016.08.001

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MTF Surgery » Surgeons

Surgeons Who Perform Gender-Affirming Surgery

Trans feminine Gender Affirming Surgery is becoming more and more common, but it can still be tough to find the right surgeon. The surgeons listed below are highly qualified plastic, reconstructive, urological and cosmetic surgeons who regularly perform gender-affirming procedures for those on the trans feminine spectrum. When choosing a surgeon, look for board certification, experience with transgender surgery, and a someone you feel confident and comfortable with.

Also see: Vaginoplasty Surgeons , Orchiectomy Surgeons

Featured Surgeons

Dr. Kathy Rumer

Dr. Kathy Rumer is an expert in transgender surgery, performing 200-250 MTF gender reassignment surgeries per year. Dr. Rumer also directs a 1-year gender surgery fellowship program. She offers the full range of male to female surgery procedures, including Vaginoplasty, Facial Feminization Surgery and Breast Augmentation. Read more »

Dr. Scott Mosser

Dr. Scott W. Mosser is a board certified and award-winning surgeon based in San Francisco who specializes in MTF/N Breast Augmentation and Body Feminization. He has worked with the transgender community for more than 10 years. Dr. Mosser is co-founder of the American Society of Gender Surgeons (ASGS), and Medical Director of the Gender Institute at Saint Francis Memorial Hospital. Read more »

Dr. Gabriel Del Corral

Dr. Del Corral is a double board-certified plastic and reconstructive surgeon who offers Vaginoplasty and other gender-affirming procedures at the Medstar Center for Gender Affirmation in Washington D.C. and Baltimore, Maryland. Fellowship trained in microsurgery, Dr. Del Corral also has expertise in reconstructive surgery, maxillofacial surgery and cosmetic surgery. He specializes in Gender Affirmation Surgery and has a particular interest in Vaginoplasty and Facial Feminization. More »

Dr. Scott W. Mosser is a board certified and award-winning surgeon based in San Francisco who specializes in MTF/N Breast Augmentation and Body Feminization. He has worked with the transgender community for more than 10 years. Dr. Mosser is co-founder of the American Society of Gender Surgeons (ASGS), and Medical Director of the Gender Institute at Saint Francis Memorial Hospital. More »

Dr. Danny Hanna

Dr. Hanna is a fellowship-trained Gender Surgeon based in Dallas, Texas. At the Hanna Gender Center, Dr. Hanna works exclusively with transgender and non-binary patients, offering gender-affirming genital surgeries as well as Breast Augmentation, Body Sculpting and Hair Grafting. More »

Newly Added Surgeons

Dr. Kenan Celtik

Dr. Celtik is a Reconstructive Urologist who specializes in gender-affirming Vaginoplasty. He is fellowship-trained in Gender Surgery and has completed 15 years of advanced medical education, including rigorous training in female pelvic reconstruction, robotic surgery and neurourology. Dr. Celtik's deep expertise and commitment to providing exceptional care and surgical outcomes make him a great choice of Vaginoplasty surgeon. He joined the Crane Center for Transgender Surgery in 2023 and is based in the San Francisco area. More »

Dr. Drew Marano

Dr. Marano is a fellowship-trained plastic and reconstructive surgeon in New York City who has deep expertise in Gender Affirmation Surgery. Dr. Marano is fellowship-trained in the full spectrum of gender-affirming procedures and is particularly passionate about Robotic Vaginoplasty and Facial Feminization Surgery. Dr. Marano's extensive training and dedication to provide the highest level of care make him a sound choice of surgeon in the New York metropolitan area. More »

Dr. Aneesh Gupta

Dr. Gupta is a triple board-certified cosmetic surgeon in Philadelphia who offers Breast Augmentation and Body Feminization surgery. Dr. Gupta's experience with gender-affirming care has informed how Jazzi Cosmetic Surgery has created a welcoming environment for all patients. Throughout your surgical journey, you can expect everyone you interact with at Jazzi to be friendly and professional. More »

Facial Feminization Experts

Dr. Joel Beck

Dr. Beck is a board certified plastic and reconstructive surgeon who has been offering gender-affirming facial surgery since 2003. Based in Charlotte, North Carolina, Dr. Beck is one of only a few FFS Surgeons in the Southeast. He also offers Breast Augmentation, Body Sculpting and Hair Grafting. More »

Dr. Gerhard Mundinger

Dr. Mundinger is a board-certified plastic surgeon with broad training and expertise in craniofacial and gender-affirming surgery. Dr. Mundinger joined the Austin branch of the Crane Center for Transgender Surgery in 2021, where he offers Facial Feminization Surgery, Vaginoplasty and Breast Augmentation. More »

Dr. Thomas Satterwhite

Dr. Satterwhite is a Plastic Surgeon in San Francisco works exclusively with transgender and non-binary patients. Dr. Satterwhite performs Facial Feminization Surgery, Vaginoplasty, Breast and Buttock Augmentation, and Body Sculpting. More »

Dr. Josef Hadeed

Dr. Hadeed is a board certified, Duke University-trained surgeon who offers gender-affirming feminizing surgery in Beverly Hills, California and Miami, Florida. Dr. Hadeed's surgical offerings include Orchiectomy, Facial Feminization, Breast Augmentation and Body Sculpting. More »

Dr. Alexander Facque

Dr. Facque is a board-certified plastic surgeon in San Francisco, California who joined the Gender Confirmation Center's team in September 2020 as a full-time Associate Surgeon with deep expertise in Facial Gender Confirmation Surgery, Breast Augmentation and Body Sculpting. Dr. Facque was introduced to gender-affirming care in 2012 and now works exclusively with transgender and non-binary patients. More »

Dr. Drew Schnitt

Dr. Schnitt is a board certified cosmetic, plastic, reconstructive and craniofacial surgeon. In practice since 2002, Dr. Schnitt's extensive experience in cosmetic and craniofacial surgery make him a great choice for Facial Feminization Surgery in Florida, as well as Breast Augmentation, and Body Sculpting. More »

Dr. Toby Meltzer

Dr. Meltzer is a plastic and reconstructive surgeon who is widely recognized as one of the leading surgeons in the field of Gender Reassignment Surgery. Dr. Meltzer has been performing MTF Surgery since 1993 and has completed over 4000 gender affirming surgeries. He performs about 200 gender reassignment surgery cases per year in Scottsdale, Arizona. More »

Dr. Christopher Salgado

Dr. Salgado is a board-certified plastic surgeon in Florida who has deep expertise in Gender Affirming Surgery. In practice for more than 20 years, Dr. Salgado performs all aspects of male-to-female surgery, from Facial Feminization and Breast Augmentation to Vaginoplasty, giving patients the opportunity to experience a continuity of care throughout their surgical transition. After many years in academic practice, Dr. Salgado opened his private practice in Miami in 2019. More »

Dr. Eric Bensimon

Dr. Bensimon has dedicated his career to helping trans women seeking FFS. With over 15 years experience in FFS, Dr. Eric Bensimon is one of the world's most experienced surgeons practicing Facial Feminization Surgery. Dr. Bensimon is based in Montreal, Canada. More »

Dr. Praful Ramineni

Dr. Ramineni is a highly experienced, board-certified plastic and reconstructive surgeon who specializes in gender-affirming top and bottom surgeries. Dr. Ramineni has more than 15 years of experience as a surgeon and performs at least 600 procedures a year. He's known for not just his exceptional surgical skills and natural-looking results, but also for his caring bedside manner and great communication style. More »

Dr. Daniel J. Freet

Dr. Freet is a board certified Plastic and Reconstructive Surgeon who offers the full spectrum of MTF Surgery procedures at the University of Texas in Houston. Leading a multidisciplinary gender surgery team, Dr. Freet performs Gender Reassignment Surgery (Vaginoplasty), as well as Facial Feminization and Breast Augmentation. More »

Dr. Angela Rodriguez

Dr. Rodriguez is a board-certified plastic surgeon in San Francisco who is dedicated full time to providing surgical care for transgender patients. She is highly proficient in gender-affirming Vaginoplasty and has a special interest in Facial Feminization. Her commitment to transforming lives and passion for social justice drove her pursuance to master transgender surgery, but it's Dr. Rodriguez's surgical skills, bedside manner and results that patients love. More »

Dr. Curtis Crane

Dr. Crane is a board-certified plastic surgeon in Austin, Texas who has deep experience with the full spectrum of male-to-female Gender Reassignment Surgery procedures. Dr. Crane and his team perform approximately 130 Vaginoplasty surgeries every year, as well as Vulvoplasty, Facial Feminization and Breast Augmentation. More »

Dr. Richard Santucci

Dr. Santucci, who spent 18 years as one of the nation's most distinguished academic Reconstructive Urologists, hasn't looked back since turning his focus to Gender Affirming Surgery. Before joining the Crane Center for Transgender Surgery, Dr. Santucci served as the Director of the Center for Urologic Reconstruction and the Specialist-in-Chief for Urology at the Detroit Medical Center. Dr. Santucci's years of experience with complex genitourinary surgery uniquely qualifies him to excel at gender-affirming genital reconstruction. More »

Dr. Ashley DeLeon

Dr. DeLeon is a board-certified surgeon who specializes exclusively in Gender Affirmation Surgery. Dr. DeLeon was fellowship trained in gender-affirming procedures by Dr. Curtis Crane. Dr. DeLeon practices in Austin, Texas at the Crane Center for Transgender Surgery, one of the busiest gender surgery practices in the world. Dr. DeLeon's special focus is on male-to-female bottom surgery procedures: Orchiectomy, Vulvoplasty and Vaginoplasty. More »

Dr. Dev Gurjala

Dr. Gurjala is a board-certified plastic surgeon in San Francisco who offers the full array of male-to-female surgery. Prior to joining Align Surgical Associates in 2019, Dr. Gurjala performed gender surgery, microsurgery, and general reconstructive and aesthetic surgery for five years in the Kaiser Permanente system in California. More »

Dr. Michael Safir

Dr. Safir is a board-certified urologist in Los Angeles who specializes exclusively in gender-affirming bottom surgery procedures. With sub-specialty certification in Female Pelvic Medicine and Reconstructive Surgery (FPM-RS), Dr. Safir is one of a handful of urologists in the world with individual fellowship training and experience in both male and female genital reconstruction. He gained signicant experience performing gender-affirming genital procedures for five years at one of the highest volume gender surgery centers in the world. More »

Dr. John Henry Pang

Dr. Pang is a double board-certified plastic and reconstructive surgeon who has also completed fellowship training in Gender Affirming Surgery. Before joining Align Surgical Associates in San Francisco, Dr. Pang completed the Transgender Surgery training program at Mount Sinai in New York City. His practice is dedicated to providing the highest level of care for his transgender and non-binary patients. More »

Dr. Heidi Wittenberg

Dr. Wittenberg is an experienced Urogynecologist in San Francisco who works exclusively with trans and non-binary patients. Dr. Wittenberg is the director of MoZaic Care, which specializes in gender affirming genital and pelvic surgeries, and a Founder Surgeon and Co-Director for the first SRC accredited Center of Excellence in Gender Confirmation Surgery, at Greenbrae Surgery Center. More »

Dr. Adam Bonnington

Dr. Bonnington is a Gender Surgeon in San Francisco who has focused his career on working with underrepresented patient populations. He joined Dr. Heidi Wittenberg at MoZaic Care as a Surgical Associate in 2020 where he works exclusively with transgender and non-binary individuals. Dr. Bonnington performs Orchiectomy and Vaginoplasty. More »

Dr. Loren Schechter

Dr. Schechter is one of the country's foremost experts on gender-affirming surgery. He is the Medical Director of the Gender Affirmation Surgery Program at Rush University Medical Center in Chicago. Dr. Schechter's outstanding surgical skills and more than 20 years experience with transgender surgery have made him an in-demand surgeon. He offers the full spectrum MTF Gender Confirmation procedures, including Breast Augmentation, single-stage Vaginoplasty, and FFS. More »

Dr. Ellie Zara Ley

Dr. Ley is a board-certified plastic surgeon who had over 15 years of training and experience in plastic surgery, craniofacial surgery and microsurgery before completing Gender Surgery training. Now based in San Francisco, Dr. Ley provides superb surgical care for those seeking Vaginoplasty, Facial Feminization and other feminizing surgeries. More »

Dr. Kathy Rumer is an expert in transgender surgery, performing 200-250 MTF gender reassignment surgeries per year. Dr. Rumer also directs a 1-year gender surgery fellowship program. She offers the full range of male to female surgery procedures, including Vaginoplasty, Facial Feminization Surgery and Breast Augmentation. More »

Dr. John Whitehead

Dr. Whitehead offers gender affirming male-to-female surgery in Florida. Dr. Whitehead was trained in the art of gender reassignment surgery by Dr. Harold Reed, the now-retired urologist who practiced at The Reed Center for decades. Dr. Whitehead offers Orchiectomy, Vaginoplasty and Vulvoplasty. More »

Dr. Dmitriy Nikolavsky

Dr. Nikolavsky is a highly regarded Reconstructive Urologist and Gender Surgeon at SUNY Upstate Medical University in Syracuse NY. In addition to offering primary Vaginoplasty surgery, Dr. Nikolavsky is also an expert at treating post-operative urinary complications and provides long term follow-up care for patients who have had Vaginoplasty. Read more »

Dr. Jonathan Keith

Dr. Keith is a fellowship-trained Plastic Surgeon in New Jersey with expertise in Gender Reassignment Surgery. In 2018, Dr. Keith co-founded the first multidisciplinary clinical program for transgender patients in New Jersey. He is the first surgeon in New Jersey to offer the full range of gender-affirming procedures, including Facial Surgery, Vaginoplasty and Breast Augmentation. More »

Dr. Nick Esmonde

Dr. Esmonde is a Gender Surgeon in Portland, Oregon who has impeccable training in Gender Affirmation Surgery and whose practice is almost exclusively focused on helping transgender and non-binary patients. Dr. Esmonde offers the full spectrum of feminizing surgeries, from Facial Feminization to Vaginoplasty. More »

Dr. Christopher McClung

Dr. McClung is a board-certified urologist in Columbus, Ohio who specializes in gender-affirming Vaginoplasty. Dr. McClung's deep experience with complex urological reconstructions provided an ideal background for becoming a Gender Surgeon. He has now performed over 200 feminizing bottom surgeries and his practice is fully dedicated to providing gender-affirming surgical care. In addition to his urology and reconstructive expertise, Dr. McClung's patients also appreciate his gentle bedside manner. More »

Dr. Min Jun

Dr. Min Jun is an exceptionally trained Reconstructive Urologist and Gender Surgeon in San Francisco who specializes in Robotic Peritoneal Flap Vaginoplasty. Dr. Jun has completed fellowship training in both Reconstructive Urology and Gender Affirming Surgery. He worked with the Crane Center for Transgender Surgery in 2020-2023 and now has his own practice in San Francisco. More »

Surgeons in Thailand

Dr. Pichet Rodchareon

Dr. Pichet Rodchareon is a board-certified plastic surgeon in Bangkok who has extensive experience performing male-to-female Gender Reassignment Surgery. Dr. Pichet is considered one of top SRS surgeons in Thailand. His training includes plastic surgery, hand surgery, craniofacial and maxillofacial surgery. More »

Dr. Kamol Pansritum

Dr. Kamol Pansritum is recognized as one of the most experienced GRS Surgeons in the world, having completed over 5,000 gender reassignment surgeries, and more than 10,000 related surgical procedures for trans women since 1997. Dr. Kamol currently performs more than 200 MTF reassignment surgeries a year at his private hospital in Bangkok, Thailand. More »

More MTF Surgeons

Dr. Michelle Lee

Dr. Lee is a board-certified and fellowship-trained plastic surgeon with high proficiency in aesthetic and reconstructive procedures for the breast and face. Widely regarded as being one of the finest plastic surgeons in the Los Angeles area, Dr. Lee possesses the perfect combination of skill, artistry, experience and compassion, which makes her ideally suited to performing gender-affirming surgery. More »

Dr. Alvina Won

Dr. Won is a board-certified Cosmetic Surgeon who is committed to providing the highest level of compassionate care in a welcoming environment for all patients. Dr. Won gained significant experience with gender-affirming surgery during a year-long cosmetic surgery fellowship with Dr. Tony Mangubat, a 20+ year veteran of transgender surgery. Based in the Seattle area, just north of Seattle, Dr. Won now devotes part of her practice to performing MTF Breast Augmentation, Buttock Augmentation and Body Sculpting. More »

Dr. Laurel Chandler

Dr. Chandler is a Harvard fellowship-trained plastic surgeon who has received specialty training in gender-affirming breast surgery. During both her residency and fellowship training, Dr. Chandler worked with established gender surgeons to learn the aesthetic nuances of transgender Breast Augmentation. Dr. Chandler provides individualized care for a diverse range of patients, up to 90% of whom are transgender and non-binary. More »

Dr. E. Antonio Mangubat

Dr. E. Antonio Mangubat is the Pacific Northwest's most sought-after surgeon for transgender surgery, with more than 20 years of experience performing procedures for trans women, including Facial Feminization, MTF Breast Augmentation, Body Sculpting and Hair Restoration. More »

Dr. Dustin Reid

Dr. Dustin Reid is a double board-certified plastic surgeon in Austin who offers Breast Augmentation, Body Feminization and Hair Restoration. Dr. Reid is committed to providing expert surgical care and guidance throughout your surgery experience. More »

Dr. Daniel Medalie

Dr. Daniel Medalie is a board certified plastic and reconstructive surgeon who has been performing gender-affirming surgeries since 1996. Based in the Cleveland area, he offers Breast Augmentation and Tracheal Shave procedures for transfeminine individuals. More »

Dr. Russell Sassani

Dr. Russell Sassani is a board certified plastic and reconstructive surgeon who has quickly become one of the most popular surgeons in the Southeastern United States for trans women. He performs Breast Augmentation, Facial Feminization and Body Sculpting in the Mami/Fort Lauderdale area. More »

Dr. Mark Youssef

Dr. Mark Youssef, Director of the Transgender Surgery Institute of Southern California, is a Cosmetic Surgeon in Santa Monica who helps clients on the trans feminine spectrum with Breast Augmentation, Body Feminization and Facial Feminization surgeries. He operates at his private surgery center, Younique Surgery Center in Santa Monica. More »

Dr. Hope Sherie

Dr. Hope Sherie is a board-certified cosmetic surgeon who has extensive training in MTF surgery procedures. Dr. Sherie offers trans women the highest level of surgical care at her practice in Charlotte, North Carolina. Procedures available include Orchiectomy and Breast Augmentation. More »

Dr. Javad Sajan

Voted #1 Best Surgeon in Seattle in 2016 and 2017, Dr. Sajan is an internationally recognized Cosmetic & Reconstructive Plastic Surgeon whose specializations include Facial Feminization and Breast Augmentation. Dr. Sajan enjoys providing gender-affirming surgical care and is honored to play a role in his patients' transitions. More »

Dr. Daniel Jacobs

Dr. Jacobs is a board-certified plastic surgeon in San Francisco, California who joined the Gender Confirmation Center in July 2022. With more than 30 years of plastic experience and a practice that's dedicated to gender-affirming care, Dr. Jacobs is a sound choice for transfeminine and non-binary individuals seeking Breast Augmentation surgery. More »

Dr. Daniel Crane

Dr. Crane is a plastic surgeon in the Miami area who has expertise in breast, body and facial surgeries. He was one of only 30 residents selected from across the country to participate in a highly specialized aesthetic fellowship training program. In 2022, Dr. Crane joined Dr. Drew Schnitt's Inspire Aesthetics.. His unique training in plastic and aesthetic surgery provides him with the knowledge and experience to help you achieve your surgery goals. More »

Dr. Charles Lee

Dr. Charles Lee is a board-certified plastic and reconstructive surgeon who has deep expertise in microsurgery and breast surgery. In practice since 2003, Dr. Lee offers MTF Top Surgery at Crane Center for Transgender Surgery in San Francisco. More »

Dr. Alan Dulin

Dr. Alan Dulin is a board-certified surgeon who has many years of experience performing Male-to-Female Surgery in the Dallas area. Dr. Dulin offers transgender women Breast Augmentation & Body Contouring, Facial Feminization Surgery and Orchiectomy. More »

Dr. Scott Harris

Dr. Scott Harris is a board-certified Surgeon with years of experience performing Male to Female Surgery in Texas. Known for his meticulous attention to detail, Dr. Harris offers a number of feminizing surgeries for trans women, including Facial Feminization Surgery, Breast Augmentation and Body Sculpting procedures. More »

Dr. Cassie Nghiem

Dr. Nghiem is an Ivy League-educated, fellowship-trained plastic surgeon in Washington, D.C. who specializes in Gender-Affirming Surgery, including Breast Augmentation and Facial Feminization. She works closely with her patients to deliver the best quality care that is aligned with their goals. Known for her advanced surgical skills, Dr. Nghiem's patients also love her friendly personality and kind demeanor. More »

Dr. Manish Champaneria

Dr. Manish Champaneria is a board-certified surgeon with extensive training and experience in plastic surgery and a special focus on reconstructive breast procedures and Facial Feminization. Dr. Champaneria practices in San Diego, California. More »

Dr. Walter Lin

Dr. Walter Lin is a fellowship-trained Plastic Surgeon in San Francisco who performs Breast Augmentation for transfeminine individuals. Dr. Lin's expertise in the areas of microsurgical reconstruction of the extremities, breast, and lymphatic systems has greatly contributed to his skill with gender-affirming Breast Augmentation. Dr. Lin joined the staff of Buncke Clinic and the San Francisco Transgender Institute in 2017. More »

Dr. Jeffrey Marvel

Dr. Marvel is a board-certified cosmetic surgeon who has developed a great reputation in Nashville and Central Tennessee for his technical skills, attention to detail and natural-looking results. Since 1997, Dr. Marvel and Marvel Cosmetic Surgery's dedicated staff have offered top-notch hospitality and care for patients seeking a wide range of cosmetic procedures, including Facial Feminization, Breast Augmentation and Hair Grafting. More »

Dr. Eric Emerson

Dr. Eric Emerson is a Board-Certified Plastic Surgeon with over 20 years experience specializing in breast surgery, body contouring and facial surgery. Dr. Emerson is a sound choice for trans women seeking breast augmentation and body and facial feminization surgery in the Carolinas and eastern United States. More »

Dr. Gregory Swank

Dr. Gregory Swank a board-certified, Duke University-trained surgeon who offers male-to-female surgery in North Carolina. Dr. Swank's surgical offerings for trans women include Breast Augmentation, and Body and Facial Feminization. More »

Dr. Michael Beckenstein

Dr. Michael Beckenstein is a double-board-certified Plastic Surgeon in Birmingham who is pleased to offer his expertise and skills in cosmetic and reconstructive surgery to the MTF community in Alabama and throughout the Southeast. Dr. Beckenstein specializes in Breast Augmentation as well as Hair Restoration. More »

Dr. Helena Guarda

Dr. Helena Guarda is a board-certified Plastic and Reconstructive Surgeon who is committed to offering Breast Augmentation and Feminization Surgeries as part of her LGBT-friendly practice in Suffolk, Virginia. Dr. Guarda is excited to work with patients from all parts of Virginia, as well as those coming from nearby states such as North Carolina, Maryland, West Virginia, Tennessee, and Kentucky. More »

Dr. Elliot Jacobs

Dr. Jacobs is a nationally-recognized, board-certified plastic surgeon in Boca Raton, Florida with more than 30 years of experience in breast and facial surgeries. Dr. Jacobs offers MTF Surgery procedures at his private, modern and fully accredited surgical suite. More »

Dr. Rex Moulton-Barrett

Dr. Rex Moulton-Barrett is a double board certified cosmetic, plastic and reconstructive surgeon in the San Francisco Bay Area who has been performing MTF Breast Augmentation surgery since 2010. Read more »

Dr. Vartan Mardirossian

Dr. Vartan Mardirossian is a surgeon in South Florida who specializes in Facial Feminization Surgery. Dr. Mardirossian has extensive training and experience performing Facial Feminization procedures, including 7 years of training under renowned FFS surgeon Dr. Jeffrey Spiegel . Read more »

Last updated: 04/03/24

Keelee MacPhee, M.D.

Transgender Surgery & Plastic Surgery

TRANSGENDER SURGERY COSMETIC PLASTIC SURGERY BOARD CERTIFIED

Gender Affirming Surgery

Dr. Keelee MacPhee has been performing gender affirming surgery since 2005 and is grateful for the ability to help patients transition to the bodies that align with who they truly are.

With a limited number of skilled transgender surgeons in the U.S., gender reassignment surgery can be difficult to obtain. Following the Standards of Care set forth by the World Professional Association for Transgender Health ( WPATH ), Dr. MacPhee performs procedures for transfeminine, transmasculine and non-binary individuals.

Specializing in transgender surgical procedures

Dr. MacPhee’s expertise includes genital reconstruction , also known as bottom surgery; facial feminization , including tracheal shave, forehead bossing, rhinoplasty and fillers; facial masculinization , including fillers and implants; and breast feminization and chest masculinization procedures.

She continues to train and develop her gender affirming surgery practice, staying abreast of new procedures and surgical advancements as they unfold.

Safe, welcoming environment at North Carolina Specialty Hospital and world-renowned Duke

Dr. MacPhee’s focus and dedication to this area of practice are what draw transgender and non-binary patients from across the country. They trust her with their healthcare not only for her skill, compassion and understanding but also for the environment in which she practices. The City of Durham is highly supportive of LGBTQ+ issues. Dr. MacPhee performs surgeries at North Carolina Specialty Hospital and Duke Regional Hospital, a recognized leader in LGBTQ+ healthcare equality. Here, patients feel at ease knowing there is no judgment and the facilities are world-class.

Contact us today for a consultation. If you are traveling from outside of North Carolina, please ask for help with your accommodations while in the Triangle. We will connect you with a safe place and nursing staff if needed.

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We are grateful for our many patients who are willing to share their experiences and results. Click … Read More >

MEET DR. MACPHEE

A highly skilled Plastic & Reconstructive surgeon in practice for more than 17 years, Dr. Keelee … Read More >

TRANSGENDER SURGERY

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Gender Reassignment

Dr. Navin Singh and his staff strive to create a comfortable and sensitive environment to help with this big life change.

Our staff can refer an OB/GYN to prescribe hormones which will help with the transformation process.

Chondrolaryngoplasty-Tracheal Shave

Reasons for Considering a Tracheal Shave

• Appear more feminine
• Soften appearance of the Adam’s apple

General Procedure

An incision is placed under the Adam’s apple, if possible inside a crease to minimize scar appearance. From there a tunnel under the skin is made until the thyroid cartilage. The cartilage is then shaved down, making the throat appear smoother and less angular.

The surgery is usually outpatient and can be done under local or IV sedation (depending on whether or not other surgeries are added).

Recovery Process

• During the first 24-28 hours, swelling may occur
• Gently massage the area to minimize scarring
• Temporary difficulty swallowing and speaking

Possible Side Effects

• Change in vocal quality

Breast Augmentation

For information, please visit our Breast Augmentation page.

Body Contouring

To help create a more feminine hourglass shape, our office offers Laser Liposuction and Fat Grafting .  We are able to transfer fat from the inner and outer thighs, calfs, abdomen, and arms to the buttock, hips and face.

Facial Feminization Surgeries

In order to achieve a more feminine appearance, there are many surgeries that we provide to soften the masculine facial features.

These surgeries may include:

• Cheek Implants
• Chin Reduction
• Fat Grafting
• Rhinoplasty

Non-Surgical Treatments

We also offer non surgical treatments to improve appearance such as Laser Hair Removal and Botox & Fillers .

For more Information on Gender Reassignment visit our site. www.NationalGenderChange.com 

PRFM for Skin Rejuvenation, Next Generation PRP!

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Are you looking for a safe, non-surgical, and effective way to rejuvenate your skin? Selphyl PRFM treatment might just be the perfect solution for you. [...]

Mounjaro’s Role in Revolutionizing Weight Loss

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Non-Surgical

Gender surgery, a consultation, what our clients say.

Great work and results. Friendly doctor with nice treatment. Highly educated with great experience. He coordinates with his staff to stay communicated with their patients before or after surgery. You can’t feel afraid during the surgery time. I would also recommend him for plastic surgery for both genders of people.

Great office staff. Dr. Singh is truly amazing at what he does. I had a great experience with my Lipo 360. I’m currently 5 days post op and I’m loving my results.

My experience with Dr. Singh and the entire staff was exceptional! He was extremely thorough and very patient. The staff was awesome too! They were kind and always had such a wonderful attitude! I’m extremely happy with my results! Highly recommend!

Dr. Singh does amazing work. All his staff are very knowledgeable and professional. I highly recommend him.

Amazing doctor! Excellent staff. Dr. Singh is a doctor that shows you that there are still excellent doctors around. He gives you great ideas and he gives you the most bang for your buck and takes your budget seriously. I am going back soon!

The purpose of my review is to highly recommend Dr. Singh for plastic surgery. I couldn’t be more pleased with his surgical skill. His office staff was incredibly helpful as well. They are approachable and well informed. I researched several surgeons in the DC metro area and visited with three. Dr. Singh was the second surgeon I visited and when I left his office, I knew he was the best surgeon for me. He understood the results I was hoping for and he was honest with me about what I should expect. His demeanor is calm, collected, and confident. His staff is truly phenomenal. I asked them a million questions and to them there wasn’t a question too personal or too mundane. They really helped me be at ease with what I was planning to do and they walked me through every step of the procedure so I knew what to expect from surgery and during the recovery process.

WOW! Dr. Singh and his staff were wonderful. After meeting him, I was no longer nervous and very excited. They made the whole process comfortable and non-scary. The results were spectacular. I looked and felt great. I got my confidence back! I was treated great and came back for the second procedure. This is the place to go! You will be happy with the quality of work and the personalized service. Thanks so much guys!!!!

Dr. Singh is absolutely amazing at his job! I’ve been his patient for about 6 years now and I continue to use his services not only because of his expertise and meticulously high standards, but also his integrity. All of the staff are professional, kind and attentive. They truly are the best in the area!

Dr. Singh and his staff are absolutely phenomenal. I am a male diagnosed with Poland’s Syndrome. I chose to have a pec implant surgery, and I could not have been happier with my results. Stunning. No longer do I feel I have to hide my abnormality with jackets and oversized shirts. I feel I have obtained a second family with the staff. I cannot say enough…simply. From recluse to social butterfly!

Washingtonian Plastic Surgery was a great place for me to get my breast augmentation done because Dr. Navin Singh is an excellent doctor and was very upfront and honest with his opinion on what would best fit me and would look as natural as possible. I am happy with my results and totally recommend anyone who wants to become a newer and better version of themselves to go here! Very comfortable environment with great customer service from the ladies at the front desk. You won’t regret it!

I was truly impressed with your nice facility, the caring staff, and friendly attitudes and smiles. The office was furnished with style and class. The doctor I saw, Dr. Navin Singh, is TRULY AMAZING, as well as the front desk staff. It was good to be treated with professionalism and care. I appreciated their follow-up and willingness to answer questions as well. All this adds up to fabulous customer service, which can be hard to come by. THANK YOU ALL SO VERY MUCH!!! You have a customer for life.

At fifty-nine (59), I had contemplated eyelid surgery for years. My upper eyelids grossly sagging & my under-eye puffiness covered an area 2″ x 2″ under the eyes. Dr. Navin Singh’s superior excellence to detail & perfection changed my life! Dr Navin Singh is the Dr’s, the patient’s & the only choice.

Dr Singh and his staff are so professional and is always available to be in contact with, not like most doctor offices around. He was very honest and made me feel very comfortable. I’m three days into my tummy tuck procedure and I will say he explained and went over everything as they would happen. I can’t yet tell my results but it’s a noticeable change. I will definitely recommend and go back for more procedures!

I know the decision to have cosmetic surgery is a big one. It can be costly, and it carries some risk, but it will change your life for the better. I used this site a lot when making my decision and I had consultations with several surgeons. I took a methodical approach, weighed all my options carefully, and I can say with full confidence that if you’re looking for a procedure that Dr. Singh performs, you should go with him, or at least have a consultation. He’s an amazing doctor and just a great person in general. His staff is as kind, patient, thorough, and knowledgeable as he is, and all of that makes a huge difference.

Dr. Singh is AMAZING!!!! I have nothing but wonderful things to say about him and his team. He is so personable and I loved that he and his team made sure that all my questions and concerns were addressed and answered. I started my journey with Dr. Singh in 2010 with a breast augmentation. I did 500cc saline, filled to 550cc. He and his staff were so supportive and helpful before, during, and after surgery. My breasts look so nature and look fantastic!!! I was so happy with my results and Dr. Singh that I went back to him for a tummy tuck with muscle repair in 2012 and now I’m going back for liposuction!

The mini-tummy tuck turned out even better than I expected

Dr. Singh, In two weeks, I didn’t have any bruising, swelling is gone, it looks so natural. I just got engaged and I look so good in my pictures. Thanks so much.

You are a VERY special man. You & Nicolette have changed my life. THANK YOU!! 🙂

7601 Lewinsville Road, Suite 300 McLean, VA 22102 (703) 345-4377

11490 Commerce Park Drive, Suite 430 Reston, VA 20191 (703) 636-9296

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The Meltzer Clinic, PC, Scottsdale, AZ

7025 N Scottsdale Rd Suite 302 , Scottsdale , Arizona , 85253 - Get Directions

Business Overview

The Meltzer Clinic, PC Scottsdale, Arizona

The Meltzer Clinic, PC is a full-service Plastic and Reconstructive Surgery Clinic specializing in Gender Affirming Surgery. Our surgeons have completed rigorous training and have significant experience in gender-affirming healthcare. They are active and participating members of WPATH and are dedicated to providing quality healthcare for all. With locations in Scottsdale, AZ, and Portland, OR, and operating out of HonorHealth Greenbaum in Scottsdale and Legacy Good Samaritan in Portland. We work with many insurance providers such as BCBS, Kaiser, Pacific Source, Washington Apple, OHP, and more.

Supports Insurance

• Blue Cross Blue Shield
• Anthem, Inc.

Service Portfolio

• Vaginoplasty
• Orchiectomy
• Facial Feminization
• Vulvaplasty
• Breast Augmentation
• Metiodioplasty

Language(s) Spoken

Contact details.

Mental Health Professionals

Dr. Ellie Zara Ley MD

Dr. Ellie Zara Ley is a Plastic and Reconstructive Surgeon, Board Certified by The American Board of Plastic Surgery. She left private practice to join the office of Dr. Toby Meltzer in December of 2015. She has had extensive training and has a true passion for working with the community; performing a wide variety of Gender Affirming Surgeries in both Scottsdale, AZ and Portland, OR. She graduated from Universidad Autonoma de Guadalajara and New York Medical College. Residency in General Surgery at the University of Arizona. Fellowships: • Craniofacial/Pediatric surgery at Primary Children’s Medical Center in Salt Lake • Hand and Microsurgery at the University of Southern California • Plastic and Reconstructive Surgery at the University of Utah Licensed and in good standing with AZ, CA, and OR Medical Boards. Published in multiple journals on reconstruction surgical care in transgender youths. She is tri-lingual in Spanish, Cantonese (conversational) and English.

Dr. Toby Meltzer MD

Dr. Toby Meltzer is a Plastic and Reconstructive Surgeon, Board Certified by The American Board of Plastic Surgery. Dr. Meltzer began performing Gender Affirming Surgeries at OHSU in 1990. He started private practice in 1996 in Portland, OR. In 2003 he relocated his practice to Scottsdale, AZ. He currently operates in both Portland, Oregon and Scottsdale, AZ and has privileges at Honor Health in Scottsdale, AZ and Legacy Good Samaritan in Portland, OR. He performs approximately 200 gender cases per year, including but not limited to: genital reconstruction, facial feminization, breast augmentation, chest surgery, repairs/revisions, and body contouring. Licensed and in good standing with AZ, CA, and OR Medical Boards. Published in multiple journals on reconstruction surgical care in transgender youths. Active and participating member of WPATH.

Dr. Nick Esmonde MD

Dr. Nick Esmonde is a Plastic and Reconstructive Surgeon who joined The Meltzer Clinic in 2020. He has since obtained extensive fellowship training from Dr. Toby Meltzer and Dr. Ellie Zara Ley in all aspects of gender surgery, including facial surgery, aesthetic surgery, chest and body surgery, and reconstructive genital surgery (e.g., vaginoplasty, phalloplasty, and metoidioplasty). He is now an Associate Surgeon for the Portland, Oregon branch of the Meltzer Clinic. Dr. Esmonde has a long-standing interest in gender surgery and transgender health. He received a Masters in Public Health from Oregon Health & Science University where he also completed his Plastic & Reconstructive Surgery residency in 2020. During his residency he received extensive training in gender surgery, as one of the few university plastic surgery programs in the country offering gender surgery training. He also worked closely with allied healthcare professionals within the OHSU Transgender Health Program, and found tremendous joy in serving the Portland transgender community in this collaborative environment. He has conducted and published original research on surgical outcomes, patient-centered care, and financial analyses to promote better quality and access to care for transgender patients. He has presented his research at national and international meetings with a focus on transgender health and also serves as a scientific reviewer for plastic surgery research journals. He is one of a few surgeons in the country that has had training both during residency and fellowship in gender surgery.

Meg Bergeson, DNP, ACNP-BC, FNP-BC , RNFA

Meg Bergeson DNP, is a board certified Acute and family Nurse Practitioner who has worked alongside Dr. Meltzer since 2011. She began her career in 1996 and has experience in pediatrics, burn, obstetrics and gynecology as well as emergency and trauma medicine.In addition to her extensive clinical experience, Meg also has an outstanding academic background that includes 2 bachelors degrees (a BS in psychology and nursing), a masters of nursing and a doctorate of nursing where most of her work revolved around transgender medicine and post-operative care. Meg’s combination of clinical education and experience provide a strong academic foundation for the continuing care of her patients.

• Dr Ellie Zara Ley MD
• Dr Nick Esmonde MD
• Dr Toby R Meltzer MD
• Female to Male (FTM) Top Surgery
• Gender Confirmation Clinic
• MTF (Male to Female) Top surgery
• Top Surgeons
• Transgender Specialists

Customer Reviews

I had extensive liposuction from Dr. Meltzer 18 years ago in Portland, OR. My results are still beautiful and healed up very well and have maintained their shape, I had 360 lipo on both my thighs which was extensive since they were so abnormally large, I also had my upper arms done at the same time. I’m recovering from breast cancer surgery and preparing for fat grafting and my current plastic surgeon complimented the work I had done, you can’t even tell that I had surgery. I have no ridges or indentations which can be quite common with this type of surgery especially on the front thighs. Thanks Dr. Toby!

I absolutely love Dr. Meltzer and his staff. They helped me out with everything and were very friendly. I got top surgery from him coming up on 2 years on Dec 21st. He fit me right into the schedule, exactly when I wanted to get my surgery done. He did an amazing job on my chest, I get a lot of compliments on it and a lot of guys jealous of how fast/much my scars have faded. I HIGHLY recommend Dr. Meltzer for anyone looking to get top surgery!

For over forty years I dreamed of the day I would feel complete. The day had come, Dr Meltzer and his entire team, whether at his office or at the Greenbaum Surgical Recovery, was met with respect and confidentiality. Dr Meltzer is a pure perfectionist and always delivered the best results. He and the entire team made this experience a comfortable one. Again I can not thank Dr Meltzer enough for enabling me to continue a life of dreams. Thank you Greenbaum team for your pleasant demeanor and help.

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Sweden passes law lowering age to legally change gender from 18 to 16

Proposal sparked intense debate in country but passed with 234 votes in favour and 94 against

Sweden’s parliament has passed a law lowering the minimum age to legally change gender from 18 to 16 and making it easier to get access to surgical interventions.

The law passed with 234 votes in favour and 94 against in Sweden’s 349-seat parliament.

While the Nordic country was the first to introduce legal gender reassignment in 1972, the new proposal, aimed at allowing self-identification and simplifying the procedure, sparked an intense debate in the country.

The center-right coalition of the conservative prime minister, Ulf Kristersson, has been split on the issue, with his own Moderates and the Liberals largely supporting the law while the smaller Christian Democrats were against it.

The Sweden Democrats, the populist party with far-right roots that support the government in parliament but are not part of the government, also opposed it.

“The great majority of Swedes will never notice that the law has changed, but for a number of transgender people the new law makes a large and important difference,” Johan Hultberg, an MP representing the ruling conservative Moderate party, told parliament.

Beyond lowering the age, the new legislation is aimed at making it simpler for a person to change their legal gender.

“The process today is very long, it can take up to seven years to change your legal gender in Sweden,” Peter Sidlund Ponkala, president of the Swedish Federation for Lesbian, Gay, Bisexual, Transgender , Queer and Intersex Rights (RFSL), told AFP.

Two new laws will go into force on 1 July 2025: one regulating surgical procedures to change gender, and one regulating the administrative procedure to change legal gender in the official register.

People will be able to change their legal gender at 16, though those under 18 will need the approval of their parents, a doctor and the National Board of Health and Welfare.

A diagnosis of “gender dysphoria” – where a person may experience distress as a result of a mismatch between their biological sex and the gender they identify as – will no longer be required.

Surgical procedures to transition would be allowed from the age of 18, but would no longer require the board’s approval. The removal of ovaries or testes will only be allowed from the age of 23, unchanged from today.

Denmark, Norway, Finland and Spain are among countries that already have similar laws.

Last Friday German lawmakers approved similar legislation, making it easier for transgender, intersex and non-binary people to change their name and gender in official records directly at register offices.

In the UK, the Scottish parliament in 2022 passed a bill allowing people aged 16 or older to change their gender designation on identity documents by self-declaration. It was blocked by the British government , a decision that Scotland’s highest civil court upheld in December.

The legislation set Scotland apart from the rest of the UK, where the minimum age is 18 and a medical diagnosis is required.

Citing a need for caution, Swedish authorities decided in 2022 to halt hormone therapy for minors except in very rare cases, and ruled that mastectomies for teenage girls wanting to transition should be limited to a research setting.

Sweden has seen a sharp rise in gender dysphoria cases. This is particularly visible among 13- to 17-year-olds born female, with an increase of 1,500% since 2008, according to the Board of Health and Welfare.

While tolerance for gender transition has long been high in the progressive and liberal country, political parties across the board have been torn by internal divisions over the new proposal.

A poll published this week suggested almost 60% of Swedes oppose the proposal, while only 22% back it.

In a sign of the strong feelings it stirred, members of parliament spent six hours debating the proposal.

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Ukraine attacked eight Russian regions with dozens of long-range strike drones, setting ablaze a fuel depot and hitting three power substations in a major attack early on Saturday, an intelligence source in Kyiv told Reuters.

The Russian defence ministry said on Saturday its air defence intercepted and destroyed 50 Ukrainian drones overnight, repelling one of the largest such attacks on Russia during the conflict in Ukraine.

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Israeli soldiers shot 2 Palestinians who attacked them, military says

The Israeli army said that its soldiers shot two Palestinians who tried to shoot and stab them in the occupied West Bank on Sunday, and the Palestinian health ministry said both men had died.

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Supreme Court Clears Way, for Now, for Idaho to Ban Transgender Treatment for Minors

The Idaho attorney general had asked the justices to move swiftly to let the state law, which would ban gender-affirming medical care for minors, go into effect.

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By Abbie VanSickle

Reporting from Washington

The Supreme Court temporarily allowed Idaho on Monday to enforce a ban on gender-affirming treatment for minors, effectively suggesting that some justices appear comfortable with wading into another front in the culture wars.

In siding with state officials who had asked the court to lift a block on the law as an appeal moves forward, the justices were sharply split, with a majority of the conservatives voting to allow the ban to take effect over the objections of the three liberals.

The court said the ban would apply to everyone except for the plaintiffs who brought the challenge.

Notably, the opinions focused not on transgender care, a hot-button political issue that has prompted several Republican-led legislatures to approve bills to restrict puberty-blocking drugs and hormone treatments, but on a broader legal question: universal injunctions.

Universal injunctions are when a single judge issues a sweeping decision that applies beyond those directly involved in the dispute. Some justices have signaled an interest in looking at the tactic.

Although orders in response to emergency applications often include no reasoning, the justices in this case divided into several factions.

The decision included concurrences by Justice Neil M. Gorsuch, who was joined by Justices Samuel A. Alito Jr. and Clarence Thomas, and Justice Brett M. Kavanaugh, who was joined by Justice Amy Coney Barrett. Chief Justice John G. Roberts Jr. did not note a position.

Justice Ketanji Brown Jackson dissented and was joined by Justice Sonia Sotomayor. Justice Elena Kagan noted a dissent.

The Idaho law, passed by the state’s Republican-controlled Legislature, makes it a felony for doctors to provide transgender medical care for minors, including hormone treatment.

States around the country have pushed to curtail transgender rights. At least 20 Republican-led states, including Idaho, have enacted legislation that limits access for gender transition care for minors.

In his concurrence, Justice Gorsuch said the use of a universal injunction “meant Idaho could not enforce its prohibition against surgeries to remove or alter children’s genitals, even though no party before the court had sought access to those surgeries or demonstrated that Idaho’s prohibition of them offended federal law.”

He wrote that the case broached the use of such injunctions, “a question of great significance that has been in need of the court’s attention for some time.” In recent years, he added, lower courts had overstepped their bounds by seeking “to govern an entire state or even the whole nation from their courtrooms.”

In her dissent, Justice Jackson also honed in on similar questions. But she wrote that the case, particularly given that it was brought on the emergency docket, was “not be the place to address the open and challenging questions that that issue raises.”

If there was any point of agreement in the case, it seemed to be a growing frustration with the number and scope of cases brought on the court’s emergency docket.

Justice Jackson noted that she saw “some common ground” with her conservative colleagues by agreeing that “our emergency docket seems to have become increasingly unworkable.”

The American Civil Liberties Union, which represents the plaintiffs in the case, denounced the outcome, saying it was “an awful result for transgender youth and their families across the state.”

“Today’s ruling allows the state to shut down the care that thousands of families rely on while sowing further confusion and disruption,” it said in a statement.

The Idaho attorney general, Raúl Labrador, a Republican and former member of Congress who helped found the conservative House Freedom Caucus, celebrated the decision.

“Denying the basic truth that boys and girls are biologically different hurts our kids,” Mr. Labrador said. “No one has the right to harm children, and I’m grateful that we, as the state, have the power — and duty — to protect them.”

Idaho officials had appealed to the Supreme Court after the U.S. Court of Appeals for the Ninth Circuit, in San Francisco, upheld a temporary block on the law as litigation continues in lower courts.

The law, the Vulnerable Child Protection Act, makes it a crime for medical providers to offer medical care to transgender teenagers.

Mr. Labrador, in his emergency application, said that the case raised a recurring question that a majority of the justices had expressed interest in: whether a court can enact a universal injunction.

Mr. Labrador contended that a federal court erred in applying the freeze so expansively. “The plaintiffs are two minors and their parents, and the injunction covers two million,” he wrote.

Temporarily barring the law meant “leaving vulnerable children subject to procedures that even plaintiffs’ experts agree are inappropriate for some of them,” he added.

Mr. Labrador continued, “These procedures have lifelong, irreversible consequences, with more and more minors voicing their regret for taking this path.”

The plaintiffs had asserted that the case was not the right vehicle for addressing concerns about universal injunctions.

That is because the four plaintiffs are anonymous, referred to only by pseudonyms. If the court narrowed the temporary pause on the Idaho law to apply only to those directly involved in the lawsuit, the plaintiffs, including minors, would be forced to “disclose their identities as the transgender plaintiffs in this litigation to staff at doctors’ offices and pharmacies every time they visited a doctor or sought to fill their prescriptions.”

Abbie VanSickle covers the United States Supreme Court for The Times. She is a lawyer and has an extensive background in investigative reporting. More about Abbie VanSickle

Sunday, April 21, 2024

Tax payer funded gender reassignment surgeries prompt questions about military readiness.

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Ohio judge temporarily blocks ban on gender-affirming care for transgender minors

A Franklin County judge on Tuesday temporarily blocked an impending law that would restrict medical care for transgender minors in Ohio.

The decision came weeks after the American Civil Liberties Union filed a lawsuit challenging House Bill 68 on behalf of two transgender girls and their families. The measure prevents doctors from prescribing hormones, puberty blockers or gender reassignment surgery before patients turn 18.

Attorneys contend the law violates the state Constitution , which gives Ohioans the right to choose their health care.

"Today's ruling is a victory for transgender Ohioans and their families," said Harper Seldin, staff attorney for the ACLU. "Ohio's ban is an openly discriminatory breach of the rights of transgender youth and their parents alike and presents a real danger to the same young people it claims to protect."

House Bill 68 was set to take effect April 24 after House and Senate Republicans  voted to override  Gov. Mike DeWine's veto. Proponents of the bill contend it will protect children, but critics say decisions about transition care should be left to families and their medical providers.

The suit in Ohio mirrors efforts in other states to challenge laws that restrict gender-affirming care for minors. A federal judge struck down a  similar policy in Arkansas , arguing it violates the constitutional rights of transgender youth and their families. The state is appealing that decision.

“This is just the first page of the book,” Attorney General Dave Yost said Monday. “We will fight vigorously to defend this properly enacted statute, which protects our children from irrevocable adult decisions. I am confident that this law will be upheld.”

What does House Bill 68 do?

House Bill 68 allows Ohioans younger than 18 who already receiving hormones or puberty blockers to continue, as long as doctors determine stopping the prescription would cause harm. Critics say that's not enough to protect current patients because health care providers could be wary of legal consequences.

The legislation does not ban talk therapy, but it requires mental health providers to get permission from at least one parent or guardian to diagnose and treat gender dysphoria.

The bill also bans transgender girls and women from playing on female sports teams in high school and college. It doesn't specify how schools would verify an athlete's gender if it's called into question. Players and their families can sue if they believe they lost an opportunity because of a transgender athlete.

The lawsuit doesn't specifically challenge the athlete ban. But it argues that House Bill 68 flouts the constitution's single-subject rule, which requires legislation to address only one topic. House Republicans introduced separate bills on gender-affirming care and transgender athletes before  combining them into one .

In Tuesday's decision, Franklin County Judge Michael Holbrook indicated that the law could be tossed out because of a single-subject violation.

"It is not lost upon this Court that the General Assembly was unable to pass the (Saving Ohio Adolescents from Experimentation) portion of the Act separately, and it was only upon logrolling in the Saving Women’s Sports provisions that it was able to pass," Holbrook wrote.

Panel clears ban on gender reassignment surgery for minors

Tuesday's decision came one day after a legislative panel cleared the way for an administrative rule that will ban gender reassignment surgery for minors. Ohio health care providers say they do not perform that procedure on patients under 18.

The rule will take effect May 3.

The measure was among several that DeWine proposed to regulate gender-affirming care after he vetoed House Bill 68. In testimony for Monday's meeting, opponents argued that the rules overstep the administration's authority and conflict with federal law.

"The proposed administrative rule changes are based on biased definitions, ignore well-established best practices and restrict countless patients’ access to gender-affirming care," said Mallory Golski, civic engagement and advocacy manager for Kaleidoscope Youth Center.

DeWine's other proposals are still working their way through the rulemaking process. That includes a requirement for transgender minors to undergo at least six months of counseling before further treatment occurs. Another rule would require providers to report non-identifying data on gender dysphoria diagnoses and treatment.

Haley BeMiller is a reporter for the USA TODAY Network Ohio Bureau, which serves the Columbus Dispatch, Cincinnati Enquirer, Akron Beacon Journal and 18 other affiliated news organizations across Ohio.

Sweden lowers gender reassignment age in controversial new law

S weden’s parliament on Wednesday passed a controversial law lowering the minimum age to legally change gender from 18 to 16 and making access to surgical interventions easier.

The law passed with 234 votes in favour and 94 against in Sweden’s 349-seat parliament.

While the Nordic country was the first to introduce legal gender reassignment in 1972, the proposal, aimed at allowing so-called “self-identification” and simplifying the procedure , sparked an intense debate.

The debate has also weakened the prime minister’s standing, after he admitted to caving in to pressure from party members on the issue.

Johan Hultberg, an MP representing the ruling conservative Moderate Party, told parliament: “The great majority of Swedes will never notice that the law has changed but for a number of transgender people the new law makes a large and important difference.”

Currently, the process of changing a person’s legal gender can take up to seven years.

Two new laws will go into force on July 1 2025: one regulating surgical procedures to change gender, and one regulating the administrative procedure to change legal gender in the official register.

People will be able to change their legal gender as of age 16, though those under 18 will need the approval of their parents, a doctor, and the National Board of Health and Welfare.

A diagnosis of gender dysphoria – where a person may experience distress as a result of a mismatch between their biological sex and the gender they identify as – will no longer be required.

Surgical procedures to transition would, like now, be allowed from the age of 18 but would no longer require the Board of Health and Welfare’s approval. The removal of ovaries or testes will only be allowed from the age of 23, unchanged from today.

A number of European countries have already passed laws making it easier for people to change their legal gender.

Citing a need for caution, Swedish authorities decided in 2022 to halt hormone therapy for minors except in very rare cases and ruled that mastectomies for teenage girls wanting to transition should be limited to a research setting.

Rise in gender dysphoria

Sweden has seen a sharp rise in gender dysphoria cases which is most visible among 13 to 17-year-olds born female, with an increase of 1,500 per cent since 2008, according to the Board of Health and Welfare.

While tolerance for gender transitions has long been high in the progressive and liberal country, political parties across the board have been torn by internal divisions over the proposal, and academics, health care professionals and commentators have come down on both sides of the issue.

A recent poll suggested almost 60 per cent of Swedes oppose the proposal, while only 22 per cent back it.

Jimmie Akesson, the far-Right Sweden Democrats leader, lamented the result of Wednesday’s vote.

“I think it’s deplorable that a proposal that obviously lacks support among the population is so casually voted through,” Mr Akesson told reporters.

Some critics had expressed concerns about biological males in women’s locker rooms and prisons and fear the simplified procedure to change legal gender will encourage confused youths to embark down the path toward surgical transitions.

Others had insisted that more study is needed given the lack of explanation for the sharp rise in gender dysphoria.

Annika Strandhall, the head of the women’s wing of the Social Democrats (S-kvinnor), told Swedish news agency TT ahead of the vote: “There is a clear correlation with different types of psychiatric conditions or diagnoses, such as autism.

“We want to pause this [age change] and wait until there is further research that can explain this increase [in gender dysphoria cases].”

Ulf Kristersson, the prime minister, had defended the proposal as “balanced and responsible”.

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Oklahoma officials tell trans pro wrestler not to compete in their state

Oklahoma’s sports commission has asked a nationally televised professional wrestling promotion to not have a transgender wrestler face off against other women wrestlers again.

Washington native Nyla Rose — who works for All Elite Wrestling (AEW) — was warned by the Oklahoma State Athletic Commission not to wrestle another woman, according to the minutes of the commission’s Jan. 3 meeting. The minutes were first reported by the blog Real Rasslin’ on Tuesday.

All of this was over a Dec. 20 match in Oklahoma City that lasted 120 seconds bell to bell between Rose and Alejandra Lion. Rose won after landing a power bomb. After the match, she took a cowboy hat off the head of a fan in the crowd and put it on her head to big applause.

Rose responded to the Oklahoma news by tweeting : “Don’t worry Oklahoma I’ll find the dastardly Transgender that *checks notes* entertained fans!!! HOW DARE THEY MAKE PEOPLE HAPPY?!!!”

The commission used the wrong pronouns for Rose in its minutes and said Rose should not have wrestled a woman. The former AEW Women’s World Champion has logged 99 wins and 47 losses while in AEW, according to the promotion’s website.

AEW CEO Tony Khan said he was disappointed by the commission’s decision, writing in a statement: “There simply should not be a climate in professional wrestling, or anywhere in our society, where transgender people face discrimination. AEW stands behind Nyla Rose, as well as all transgender athletes and transgender people, who are impacted by discrimination.”

Transgender athletes have become a hotly debated topic in the broader culture wars, divided roughly into conservatives often arguing it isn’t fair to other competitors and liberals saying it invalidates gender identities when people who identify as women can’t compete against women. Battles over roster makeups have made their way into the courts , and to the desk of President Biden .

Now, the debate has made it to a place that subverts the binary of supposed reality every week on television: professional wrestling, where the outcomes are predetermined. It is theater, not sport. (Intergender pro wrestling happens but is rare in major promotions.)

Oklahoma sports commission member Larry Lovelace made a motion Jan. 3 to “warn AEW not to do this again or there will be punitive action,” according to the minutes. The motion was unanimously approved.

The Washington Post called Lovelace’s office for comment Thursday, but the call immediately disconnected when a reporter identified himself and asked for Lovelace. A follow-up call was sent to voice mail. The message had not been returned as of Thursday afternoon.

The commission indicated in its minutes that it considered Rose indicating that she is a woman on her wrestling license application part of its problem. Applications for boxing, kickboxing and MMA all require athletes to indicate whether they have had gender reassignment surgery, but the wrestling application does not, according to the minutes. The commissioners said they would add the question “so this doesn’t happen in the future.”

Oklahoma apparently https://t.co/Ta9lMwc4s4 — 🪓NYLA “the rizz” ROSE (THE REAL ONE) 🥀 (@NylaRoseBeast) April 18, 2024

Victor Mukhin

• Scientific Program

Title : Active carbons as nanoporous materials for solving of environmental problems

However, up to now, the main carriers of catalytic additives have been mineral sorbents: silica gels, alumogels. This is obviously due to the fact that they consist of pure homogeneous components SiO2 and Al2O3, respectively. It is generally known that impurities, especially the ash elements, are catalytic poisons that reduce the effectiveness of the catalyst. Therefore, carbon sorbents with 5-15% by weight of ash elements in their composition are not used in the above mentioned technologies. However, in such an important field as a gas-mask technique, carbon sorbents (active carbons) are carriers of catalytic additives, providing effective protection of a person against any types of potent poisonous substances (PPS). In ESPE “JSC "Neorganika" there has been developed the technology of unique ashless spherical carbon carrier-catalysts by the method of liquid forming of furfural copolymers with subsequent gas-vapor activation, brand PAC. Active carbons PAC have 100% qualitative characteristics of the three main properties of carbon sorbents: strength - 100%, the proportion of sorbing pores in the pore space – 100%, purity - 100% (ash content is close to zero). A particularly outstanding feature of active PAC carbons is their uniquely high mechanical compressive strength of 740 ± 40 MPa, which is 3-7 times larger than that of  such materials as granite, quartzite, electric coal, and is comparable to the value for cast iron - 400-1000 MPa. This allows the PAC to operate under severe conditions in moving and fluidized beds.  Obviously, it is time to actively develop catalysts based on PAC sorbents for oil refining, petrochemicals, gas processing and various technologies of organic synthesis.

Victor M. Mukhin was born in 1946 in the town of Orsk, Russia. In 1970 he graduated the Technological Institute in Leningrad. Victor M. Mukhin was directed to work to the scientific-industrial organization "Neorganika" (Elektrostal, Moscow region) where he is working during 47 years, at present as the head of the laboratory of carbon sorbents.     Victor M. Mukhin defended a Ph. D. thesis and a doctoral thesis at the Mendeleev University of Chemical Technology of Russia (in 1979 and 1997 accordingly). Professor of Mendeleev University of Chemical Technology of Russia. Scientific interests: production, investigation and application of active carbons, technological and ecological carbon-adsorptive processes, environmental protection, production of ecologically clean food.   

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