September 19, 2013

The Science Behind GRS


Any transgender individual thinking about or heading towards gender-reassignment surgery [GRS] must wonder, at some point, exactly what’s involved. Questions like, “Do they really know what they’re doing?” And “How do they make sure it … you know …. works?!” must occur to most of us. I know they’ve occurred to me. I’m happy to say I’ve found the science that says “Yes, they do know what they’re doing!”

In fact, I’ve found a whole lot of science on effective and successful GRS. Frankly, for something that’s frowned upon and misunderstood by society in general, I am gobsmacked with how much has been written and published about GRS. Below is a sampling of the copious articles out there about SRS. Click on a few of them … if you dare:

Althaus, 2006Amend, et al. 2013Antoszewski, et al, 2012Bettocchi, Ralph, & Pryor, 2005;Chesson, et al, 1996;  Dabernig, et al, 2007De Cuypere, et al, 2005Fang, Chen, & Chen, 2003Hage, 1995Jarrar, Wolff, & Wiedner, 1996;  Klein & Gorzalka, 2009Imbimbo, et al, 2009Lawrence, 2003Lawrence, 2005Lawrence, 2006Lief & Hubschman, 1993Ligouri, et al, 2005Monstrey, et al, 2001Monstrey, Ceulemans, & Hoebeke, 2011Rehman & Melman, 1999Rehman, et al, 1999Siemssen & Matzen, 1997Sobriaske, 2005Sohn, et al, 1996Soli, et al, 2008; Wierckx, et al, 2011

[A note about terminology: sometimes, the literature refers to it as gender reassignment surgery, sometimes sex-reassignment surgery, sometimes transsexual surgery, sometimes by more specific names like vaginoplasty and phalloplasty. They also strongly prefer the term transsexual over transgender, as transsexualis more technically accurate from a medical point of view.]

Please note that I’ve provided only a partial list. There’s so much that trying to select a few representative articles, or to summarize them all individually, would be futile. I’ll instead try to generalize what I’ve been reading.

First, note that research into this subject has been appearing in the literature for decades. While transgender may have been a stigmatized and ostracized condition socially, the medical community has not been lacking for pioneers ready to explore GRS and publish their results. There are articles out there on techniques for GRS, on the outcomes for GRS, and on the satisfaction of GRS subjects, and even some of the less pleasant-sounding complications post-surgery. The journals are packed with GRS articles.

And wow, have some of these people put a lot of thought into it! GRS is more than just flipping a scrotal sack inside out. Some of these articles are literally how-to manuals for turning penises into neovaginas or vaginas into neopenises. Ever heard of a Cowper’s gland? In men, it’s the gland that excretes pre-ejaculate to help lubricate things for the oncoming sperm. I did not know this until I read a paper explaining how the Cowper’s gland is retained during a vaginoplasty so as to provide lubrication in the neovagina during sex. Yes, they get that detailed.

The good news is that techniques are advanced nowadays, and outcomes are good. Techniques have been tested, and refined, an tested again, so that GRS today almost seems routine. Various reports in the last decade have cited high satisfaction with GRS; and in general, GRS genitals are functional and satisfying. There are complications, but those have been written about as well.

I’m glad it’s good news on the science front. GRS is potentially the most important surgery a trans person will ever undergo. It is literally transformative. I am comforted to know that the surgeons out there doing GRS today are doing so with plenty of research on their side and with techniques that are several iterations old.

[An early draft of this article appeared at Ali Finds Her Self]

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