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Workshop Highlight: W35 Confirmation Surgery in Gender Dysphoria

Thursday 27 Jul 2017 {{NI.ViewCount}} Views {{NI.ViewCount}} Views

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We highlight one of the ICS Committee workshops to give you a taste of what is available. However don't delay, other workshops are being sold out, so get planning and book your educational programme.

Confirmation Surgery in Gender Dysphoria: current state and future developments


The surgical care of individuals suffering from gender dysphoria has undergone rapid transformation over the last several years. While not all individuals with gender dysphoria need or desire surgery, many do. With an increased recognition as to the importance of surgical therapy, coupled with improved access to care, more individuals are seeking surgery.

Congruent genitalia allow an individual to experience harmony between their body and their self identity, appear nude in social situations without violating taboos (ie health clubs, physician offices, etc…), and have legal identification concordant with their physical appearance.

The World Professional Association for Transgender Health (WPATH) developed the The Standards of Care to help provide “the highest standards” of care for individuals. The Standards of Care state that the overarching treatment goal is “…lasting personal comfort with the gendered self, in order to maximize overall health, psychological well-being and self-fulfillment.” Toward this end, gender confirmation surgery helps to provide the appropriate physical morphology and alleviate the extreme psychological discomfort of the patient.

This course will cover the state-of-the-art in gender confirmation surgery. Topics covered will include:

  • The multi-disciplinary nature of care
  • The Standards of Care (WPATH, SOC, version 7)
  • The various genital surgical procedures

This will entail a description of the preoperative, intraoperative, and post-operative management of individuals undergoing both transfeminine and transmasculine surgical procedures. In addition, both prevention and management of complications will be addressed.

The transfeminine genital surgery lecture will include vaginoplasty, both penile inversion and intestinal vaginoplasty approaches will be discussed. This topic covers clitoroplasty, labiaplasty (for both labia majora and minora), urethroplasty, and dissection of the vaginal space.

The transmasculine procedures include metoidioplasty (lengthening of the hormonally hypertrophied clitoris) and phalloplasty (radial forearm and anterolateral thigh flap techniques). Within these lectures, construction of the perineal and penile urethra will be described, as well as scrotoplasty, glansplasty, and the staged placement of testicular implants and penile prostheses. Strategies to minimize and prevent complications will be reviewed. In addition, secondary procedures such as mons lift/reduction will also be discussed.

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