Gender Change Surgery in Thailand

Thailand is known to accommodate a large transgender population in the world for Gender Reassignment Surgery and it is one of the most accepting cultures.

Every year, the number of international patients traveling to Thailand to undergo sex change surgery continues to increase. Health care in Thailand offers affordable prices, highly trained and experienced surgeons, and the culture's open-mindedness towards gender identity makes the Country the Gender Reassignment Capital of the World.

Gender identity is a very important characteristic of human beings, and a change in sexual identity is a vital change that a person can experience.

Gender Identity Disorder (GID) or gender dysphoria is defined by an intense, persistent feeling of identification with the opposite gender and discomfort with one’s own assigned sex.

The ratio of the Thai/ Foreign MTF (Male to Female) transsexual patients operated in Thailand:

Time period	Thai/ Foreigners
1985–1990	95%/5%
1991–1995	90%/10%
1996–2000	75%/25%
2001–2005	50%/50%
2006–2010	30%/70%
2006–2010	30%/70%
2010–2012	10%/90%

What is Sex Reassignment Surgery (Gender Change Surgery)?

Sex reassignment surgery (SRS) is a surgical procedure, or a series of procedures, that alters a transsexual person's physical appearance and sexual characteristics to resemble those associated with their identified gender.

The term SRS is also known as Gender Reassignment Surgery (GRS), Gender Confirmation Surgery (GCS), and several other names.

Professional Medical Organizations have established Standards of Care, which apply before someone can opt for and receive reassignment surgery, including psychological evaluation, and a period of real-life experience living in the desired gender.

Sex Reassignment Surgery (SRS) involves multiple procedures which can be performed on males or females who are transitioning into the opposite gender, respectively.

Feminization Surgeries (Male to Female)-

• Vaginoplasty

• Penile inversion

• Bowel vaginoplasty

• Vulvoplasty

• Orchiectomy

• Chest reconstruction

Vaginoplasty: 

Vaginoplasty is a surgical procedure in which neovagina or neovulva is constructed from existing genital or abdominal tissue.

During a vaginoplasty, the surgeon forms the inner and outer labia of the vagina by utilizing skin from the penis and scrotum. Tissue from your other body parts can also be used such as a foreskin to build a vaginal opening, create a clitoris with skin from your penis, and create a new urethra so you can urinate.

After the vaginoplasty surgery, you will have to stay in the hospital for about five days. 

Aftercare - For six months, you will need to dilate your vagina two to three times a day with the help of a lubricated dilator by inserting into the vaginal canal and holding it there for a set number of minutes. 

 

Penile Inversion:

Penile inversion is a common vaginoplasty technique. The testicles and scrotum are removed and the glands of the penis are made into a clitoris.

 

Bowel Vaginoplasty:

Bowel vaginoplasty is a common type of vaginoplasty technique. 

As with penile inversion, in vaginoplasty the testicles and scrotum are removed, the glands made into a clitoris, and the neovulva constructed from scrotal and urethral tissue.

 

Vulvoplasty:

In Vulvoplasty, the surgeon takes tissue from the penis to create the external parts of the vagina such as the clitoris, inner and outer labia, the vaginal opening. 

After a Vulvoplasty, patients will have to stay in the hospital for three days.

 

What is the difference between Vulvoplasty and Vaginoplasty?

The main difference between a vulvoplasty and a vaginoplasty is the absence of a vaginal canal. A vulvoplasty is not performed to create a vaginal canal, so you cannot have vaginal intercourse after a vulvoplasty.

 

Orchiectomy:

Orchiectomy is the surgical process by which testicles are removed from the body. It is a much simpler procedure as compared to vaginoplasty or vulvoplasty and can be performed under local anesthesia in under 20 minutes. 

The benefit of orchiectomy - the body will naturally produce less testosterone.

Recovery is usually mild, although some may experience bruising or bleeding for a few days after surgery.

It may be performed with or without the removal of the scrotum.

 

Tracheal Shave:

A tracheal shave is a procedure done to reduce the size of an Adam’s apple, often it is done as part of facial feminization surgery. 

Procedure - the surgeon will make a small incision under the chin, folding back the muscles covering the thyroid cartilage, and then stitch up the incision.

 

Chest Reconstruction:

This procedure is for transgender men to transition physically to their self-affirmed gender.

In this, a special technique is used to reshape and reduce the chest wall, adjust the nipple and areola, and reduce scarring.

Note - Research suggests that most transgender men are satisfied with the results of their surgery.

 

Masculinization Surgeries (Female to Male)-

Before starting the female-to-male gender-affirming surgery, a person will receive testosterone replacement therapy.

• Hysterectomy and bilateral salpingo-oophorectomy

• Genital reassignment (Genital reconstructive procedures)

• Phalloplasty

• Metoidioplasty

• Penile implants

• Facial masculinization

 

Hysterectomy and Bilateral Salpingo-Oophorectomy:

A hysterectomy is a surgical procedure performed to remove the uterus.

• total hysterectomy includes the removal of the uterus and cervix

• Bilateral salpingo-oophorectomy (BSO) is the removal of the ovaries and fallopian tubes.

 

Hysterectomy can be performed through three methods: 

• Abdominal

• Laparoscopic

• Vaginal

 

After SRS treatment, patients may need to follow a lifelong course of masculinizing or feminizing hormone replacement therapy.

 

Phalloplasty:

Phalloplasty is done to construct a neopenis using a flap (graft) from the patient's arm, thigh, abdomen, or back.

Complication:

• Scarring in the area where the graft was taken

• Skin graft failure or tissue death

 

Metoidioplasty:

A metoidioplasty is a process of constructing a new penis or neopenis.

Metoidioplasty is performed after the clitoris has been enlarged using hormone replacement therapy. The neopenis is built through an enlarged clitoris, with or without extension of the urethra to allow urine to flow while standing. 

The surgeon also removes the vagina, during the surgery.

The advantage of a metoidioplasty is that the neopenis may become erect, due to the erectile abilities of clitoral tissue but neopenis resulting from a metoidioplasty is often too small for penetrative sex.

A metoidioplasty procedure typically takes 2–5 hours. 

Note: Following the initial surgery, additional procedures may be necessary.

Penile Implants:

A penile implant is used for phalloplasty surgery when the neophallus is to achieve a proper erection. Penile implants are used in cisgender men to treat erectile dysfunction, and in transgender men during Gender Reassignment Surgery. The cost of penile implant in Thailand ranges between USD 5500 and USD 6500.

Facial Masculinization:

Facial masculinization alters anatomical features to achieve an appearance that aligns more closely with desired gender identity. 

This can be achieved by:

• Surgical options - by reconstruction of the forehead, nose, upper lip, or chin. 

• Non-surgical options - with injections to alter the jawline and chin.

Recovery:

The recovery time from Sex Reassignment Surgery varies, depending on the procedure and factors such as the person’s overall health and lifestyle choices. For example,

• Smoking slows down the healing process and increases the risk of complications following surgery.
  If a person smokes or uses any substance with nicotine, the medical team may not consider them eligible for this type of surgery.

• After gender-affirming surgery, most people need to stay in the hospital for at least a couple of days, rest and only engage in very limited activities for about 6 weeks or longer.

• In the case of the urethral extension procedure, the patient needs to use a catheter for 3–4 weeks.

 

What are the complications that might occur after gender-affirming surgeries?

• Urethral fistula — it is a tunneled connection that forms between the urethra and another part of the body

• Urethral stricture — it is a narrowing that causes a blockage of urine flow within the urethra

• infection

• bleeding

• reactions to anesthesia

• dissatisfaction with the results
   

How much does Sex Reassignment Surgery in Thailand costs?

The cost of a Sex Reassignment Surgery (SRS) in Thailand is nearly one-third the price of those performed in the U.S. 

Thailand is leading in the manner of health care facilities, affordable prices, as well as surgeons trained to perform a gender transformation procedure.

• Cost for Male-to-Female Surgery (MTF) - 
  The average gender reassignment surgery cost in Thailand for male-to-female (MTF) ranges around 257,250 THB (8,400 USD) to 577,500 THB (18,850 USD), depending on the procedure you opt for. 
  Some clinics in Thailand even provide lower male-to-female (MTF) gender reassignment surgery prices which can be as low as 89,000 THB (2,948 USD). 
  However, this cost might not be all-inclusive.

•  Cost for Female-to-Male Surgery (FTM) -
  The average gender reassignment surgery cost in Thailand for female-to-male procedures ranges from around 74,000 THB (2,451 USD) to 336,000 THB (11,130 USD), depending on the clinic or hospital chosen. 

 

Top Hospitals for Gender Reassignment Surgery

• Yanhee Hospital, Bangkok 
  Established in 1984, Yanhee Hospital is a multi-specialty treatment center providing healthcare services to both national and international patients.
  The broad range of cosmetic and plastic surgery services offered in the hospital, from breast augmentation, facelift, tummy tuck, liposuction, botox injection, dental whitening, facial treatment, hair transplant, butt lift, cheek implants, cosmetic gynecology, etc., makes it an ideal stop for beauty and cosmetic needs.
• Kamol Cosmetic Hospital, Thailand
  The center was founded by Dr. Kamol Pansritum, who is one of the best surgeons for gender reassignment surgeries.
  The hospital performs over 700 sex reassignment surgeries and other procedures per year successfully and has gained a position worldwide as one of the leading centers in sex reassignment surgery (SRS) and cosmetic surgery.
• Bumrungrad International Hospital, Bangkok
  It is a one-stop healthcare destination for all types of patients with the ability to handle complex care needs.
  The Hospital is a global pioneer in giving the best international standard healthcare services and one of the largest private multi-specialty hospitals in South East Asia with patients coming from over 190 countries annually.

 

Top Doctors for Gender Reassignment Surgery

• Dr. Krairit Tiyakul
  Dr. Krairit Tiyakul is a plastic surgeon having more than 30 years of expertise.
  Services provided by him include eyelid uplift surgery, chin advancement and implant, facelift surgery, mandible angle reduction, nose augmentation, nose lift, and many more. 
• Dr. Pramote Manurangsee
  Dr. Pramote Manurangsee has a rich 20 years of experience in cosmetic surgeries.
  He provides services like breast augmentation, Face Lifting, Breast Lift Surgery, Breast Reconstruction Surgery, Liposuction, and many more. 
• Dr. Kamol Pansritum
  Dr. Kamol Pansritum is one of the renowned Plastic Surgeons in Bangkok, Thailand, having 27 years of experience.
  He performs more than 2,000 male-to-female sex reassignment surgeries each year.
  Since 1997, he has performed over 10,000 related procedures on transsexuals and over 5,000 sex reassignment surgeries.
• Dr. Akaradech Attainsee
  Dr. Akaradech Attainsee is a well-known Plastic Surgeon with 23 years of experience.
  His specialization is in face modifying surgery and has performed more than 100 face surgery cases.
• Dr. Preeyaphas Nilubol
  Dr. Preeyaphas Nilubol is one of the most reputed Plastic & Reconstructive Surgeons having 57 years of rich experience.
  He did MD from Siriraj Hospital, Mahidol University, Thailand, in 1964 and Diplomate of The American Board of Plastic Surgery in 1973.
   

Conclusion:

Thailand offers high-standard medical services to native citizens and to foreign medical travelers seeking medical care. Since Thailand offers health care services at much lower prices, and with its advanced techniques for gender reassignment procedures which is why it is the most preferred destination for people looking for quality medical services.