Stanley Biber, 406 First National Bank Building, Trinidad, Colorado 81082, USA
Method-Penile Inversion
Related Links:
Vulvas of Transsexual Women: Stanley Biber
http://members.aol.com/tssource/biber.html. Images of post-op male-to-female
transsexual vulvae from patients of Stanley Biber
J Eldh, Department of Plastic Surgery Karolinska Hospital Stockholm, Sweden Telephone:: +46 8 729 2000 Fax: +46 8 729 2505
JJ Hage, Plastic Surgeon, Academisch Ziekenhuis Vrije Universiteit afd. Plastische en Reconstructieve Chirugie, Amsterdam 1007 MB, PO Box 7057, The Netherlands, Fax: +31 20-4440151. Sex changes are not done for foreign clients, only for clients known to the Amsterdam gender team.
Recommended readings:
Karim RB, Hage JJ, Bouman FG, Dekker JJML, The importance of near total resection of the corpus spongiosum and total resection of the corpora cavernosa in the surgery of male to female transsexuals. Ann Plast Surg 1991; 26: 554-557
Hage JJ, Bouman FG, Surgical depilation for treatment of pseudofolliculitis or local hirsutism of the face: experience in the first 40 patients. Plast Reconstr Surg 1991; 88: 446-51
Hage JJ, Bouman FG, Silicone genital prosthesis for female-to-male transsexuals Plast Reconstr Surg 1992; 90: 516-519
Hage JJ, Bloem JJAM, Transsexualiteit; IV chirurgische mogelijkheden [Transsexualism IV: Surgical possibilities Nederl Tijdschr Geneeskd 1992; 136: 1901-1906
Hage JJ, Reinnervation of the cutaneous part of the free fibula osteocutaneous flap for reconstruction of the phallic (letter) Plast Reconstr Surg 1993; 91: 193
Hage JJ, Bloem JJAM, Review of the literature on the construction of a neourethra in female-to-male transsexuals Ann Plast Surg 1993; 30: 278-286
Hage JJ, Bout CA, Megans JAJ, Bloem JJAM, Phalloplasty in female-to-male transsexuals: what do our patients ask for? Ann Plast Surg 1993; 30: 323-326
Hage JJ, Bloem JJAM, Bouman FG, Obtaining rigidity in the neophallus of female-to-male transsexuals: A review of the literature Ann Plast Surg 1993; 30: 327-333
Hage JJ, Blouman FG, Bloem JJAM, Construction of the fixed part of the neo-urethra in female-to-male transsexuals: experience in 53 patients. Plast Reconstr Surg 1993; 91: 904-910
Hage JJ, Bouman FG, Bloem JJAM, Constructing a scrotum in female-to-male transsexuals Plast Reconstr Surg 1993; 91: 914-921
Hage JJ, Bouman FG, Graaf FH de, Bloem JJAM, Construction of the neophallus in female-to-male transsexuals: the Amsterdam experience J Urol 1993; 149: 1463-1468
Hage JJ, Bouman FG, Bloem JJAM, Preconstruction of the parts pendulans urethrae for phalloplasty in female-to-male transsexuals Plast Reconst Surg 1993; 91: 1303-1307
Hage JJ, A new method for clitoroplasty? (letter) Plast Reconstr Surg 1993; 91: 1364
Hage JJ, Torenbeek R, Bouman FG, Bloem JJAM, The anatomic basis of the anterior vaginal flap used for neourethra construction in female-to-male transsexuals Plast Reconstr Surg 1993; 92: 102-108
Hage JJ, Graaf FH de, Bouman FG, Bloem JJAM, Sculpturing the glans in phalloplasty Plast Reconstr Surg 1993; 92: 157-161
Hage JJ, Graaf FH de, Hoek J van de, Bloem JJAM, Phallic construction if female-to-male transsexuals using a lateral upper arm sensate free flap and a bladder mucosa graft Ann Plast Surg 1993; 31: 275-280
Hage JJ, Bloem JJAM, Suliman HM, Review of the literature on techniques for phalloplasty with emphasis on the applicability in female-to-male transsexuals J Urol 1993; 150: 1093-1093
Hage JJ, Graaf FH de, Addressing the ideal requirements by free flap phalloplasty: some reflections on refinements of technique. Microsurgery 1993; 14: 592-598
Noordanus RP, Hage JJ, Late salvage of a `free flap' phalloplasty-a case report Microsurgery 1993; 14: 599-600
Hage JJ, Invited Comment to: One-stage total penile reconstruction with a free sensate osteocutaneous fibula flap Plast Reconstr Surg 1993; 92: 1324-1325
Hage JJ, On the priority of phalloplasty by forearm flap (letter) J Reconstr Microsurg 1994; 10: 57
Hage JJ, Karim RB, Bloem JJAM, Suliman HM, Alphen M van, Sculpturing the neoclitoris in vaginoplasty for male-to-female transsexuals Plast Reconstr Surg 1994; 93: 358-364
Hage JJ Human gonads cross sex transplantation in transsexuals (letter) Plast Reconstr Surg 1994; 94: 564-565
Hage JJ, Phalloplasty for female transsexuals (letter) Microsurgery 1994; 15: 895
Hage JJ, Medical requirements and consequences of sex reassignment surgery. Med Sci Law 1995; 35: 17-24
Hage JJ, Bloem JJAM, Chest wall contouring for female-to-male transsexuals: Amsterdam experience Ann Plast Surg 1995; 34: 59-66
Hage JJ, Haumann G, Masculinisierende Techniken bei intersexuellem mannlichen Genitale und bei Frau zu Mann Transsexualismus [Masculinizing surgery for indersexes with masculine genitalia and female-to-male transsexuals] Gynakologe 1995; 28: 48-53
Karim RB, Hage JJ, Dekker JJML, Schoot C, Evolution of the methods of neovaginoplasty for vaginal aplasia Eur J Obstet Gynecol 1995; 58: 19-27
Hage JJ, Karim RB, Asscheman H, Bloemena E, Cuesta MA, Unfavourable long-term results of rectosigmoid neocolpopoiesis Plast Reconstr Surg 1995; 95: 842-848
Hage JJ Invited Comment to: Analysis of 136 cases of reconstructed penis using various methods Plast Reconstr Surg 1995; 95: 1083-1084
Hage JJ, Kesteren PJM van Chester wall contouring for female-to-male transsexuals: basic considerations and review of the literature Plast Reconstr Surg 1995; 96: 386-391
Hage JJ, Fayman MS Masculinizing surgery for male intersexes and female-to-male transsexuals
Med Sex J S Afr 1995; 6: 5-13
Karim RB, Hage JJ, Bouman FG, Ruyter R de,
Kesteren PJM van Refinements of pre, intra, and postoperative care to prevent complications of vaginoplasty in male transsexuals Ann Plast Surg 1995; 35: 279-284
Hage JJ Invited Comment to: Twenty years of experience in managing gender dysphoric patients: I. Surgical management of the male transsexual Plast Reconstr Surg 1995; 96: 931-932
Hage JJ Metaidoplasty: an alternative phalloplasty technique in transsexuals Plast Recontr Surg 1996; 97: 161-167
Becking AG, Tuinzing DB, Hage JJ, Gooren LJG Facial corrections in male to female transsexuals: a preliminary report on 16 patients J Oral Maxillofac Surg 1996; 54: 413-418
Karim RB, Hage JJ, Cuesta MA Rectosigmoid neocolpopoiesis for male-to-female transsexuals: the Amsterdam experience Ann Plast Surg 1996; 36: 388-391
Hage JJ, Karim RB, Bloemena E Labial masses following vaginoplasty in male transsexuals: The differential diagnosis Plast Reconstr Surg 1996; 97: 1226-1232
Hage JJ, Winters HRH Salvage of a "free flap" phalloplasty by distal arteriovenous fistula: case report J Reconstr Microsurg 1996; 12: 279-282
Hage JJ, Karim RB Sensate pedicled neoclitoroplasty for male transsexuals: Amsterdam experience in the first 60 patients Ann Plast Surg 1996
Hage JJ Dynaflex prosthesis in total phalloplasty Plast Reconstr Surg 1997
Hage JJ, Becking AG, Graaf FH de, Tuinzing DB Gender confirming facial surgery: considerations on masculinity and femininity of faces Plast Reconstr Surg 1997
Toby R. Meltzer, MD Crown Plaza, 1500 SW 1st Ave., Suite 1120, Portland, OR 97201 Phone: (800) 525-2426, or (503) 525-9323; fax (503) 525-0370
Dr. Meltzer performs GRS and other major procedures at Eastmoreland Hospital in Portland; all post-operative care is routinely provided at Eastmoreland, although a few patients choose to stay in a nearby hotel after the first four days. Dr. Meltzer performs outpatient procedures both at Eastmoreland and at his office.
A correspondent states:
"I had outpatient surgery at Eastmoreland (labiaplasty) on November 21, 1996, and stayed overnight in the "VIP" unit, their term for post-operative extended care. I was favourably impressed by their facilities and staff, and think that services there will get even better with experience."
Dr. Meltzer's office address is located just south of the Marriot Hotel on the waterfront. There is validated parking in a garage immediately west of Crown Plaza, with a connecting covered walk-way.
Surgery should be scheduled at least eight weeks in advance; but realistically, you should try to schedule at least six months in advance. A $500 deposit is now required to hold a reservation. Recommendations from two qualified professionals are required. The surgical fee is $11,650, $10950 if you won't be staying in the VIP unit the whole time, payable two weeks in advance by certified check, VISA, or Mastercard; this covers all major costs, including surgeon's fee, hospital charges, and anaesthesia.
You need to stop your hormones three weeks prior to surgery.
Unless otherwise directed by your physician, do not take any Aspirin, Vitamin-E, ornon-steroidal anti-inflammatory ie Advil, Aleve, Ibuprofen, three weeks prior to your surgery, since this interferes with normal blood clotting. If you need a pain medication for general purposes, use Tylenol or if you are in doubt about any medications you are taking, please contact our office.
Things to Bring:
Other Things to Bring, If You are NOT Staying in the VIP Unit:
Other Suggestions:
The total prepay cost of surgery, which includes hospital, surgical, and anaesthesia fees, is $10,950. The cost of the VIP unit is $100 per day. Should you choose to stay in the VIP unit the additional seven days, the total cost of the surgery is $11,650. If you do not use all seven days in the VIP unit, you will be promptly refunded the difference. These fees are payable two weeks in advance the form of Visa/MasterCard or a cashier's check made payable to Toby R. Meltzer, M.D. This fee covers hospital, anaesthesia, and surgeon's fees. Post-operative pain medications and pathology fees are not included, routine pathology for examination of the testicles is approximately $100. If you chose to have a secondary labioplasty the cost is $1500 and it is done as an outpatient procedure.
I hope this information has been useful to you. If you have any questions, please feel free to call.
©1998 Anne A. Lawrence
Yvon Menard and Pierre Brassard, 1003 Boul. St-Joseph Est, Montreal, Quebec H2J 1L2, Canada perform:
| Male to Female | Female to male |
| Skin inversion vaginoplasty | Free forearm flap phalloplasty |
| Adam's apple shaving | Metaidoioplasty(clitoris to penis conversion) |
| Voice surgery | Subcutaneous mastectomy |
| Breast augmentation | Hysterectomy (being organized) |
The Centre Metropolitain de Chirurgie Plastique (CMCP) or Clinic is a fully equipped, state-of-the-art private hospital. It is a modern, totally functional operating facility with all the necessary commodities and monitoring devices for a comfortable and secure stay. The Clinic is a three story building with 17 beds, three operating rooms, preop and wake up wards. Most of the surgical procedures are performed at the Clinic. Minor surgeries under local anesthesia are the exceptions and are done at the Office. At the Clinic you benefit from a 24-hour nursing staff and your personal surgeons are always on call in case of an emergency. If necessary for special health problems, consultants are available. The Clinic is a five minute walk from the residence.
Our Office is located in the center of Montreal. It is a comfortable consultation office with surgical facilities for minor procedures under local anesthesia. It will be your reference point to get all the information and answers you need.
Before surgery, you will meet your surgeon at the office and have the opportunity to discuss with him the final details of your desired surgery. Our secretaries and administrative assistants will help you with all the paperwork.
The Residence is the first place you will be driven to when you arrive in Montreal. This convalescence home has eleven beds, a private backyard, a heated outdoor pool and is very functional. There you will find a comfortable place to rest and relax after your trip. Your doctors, a registered nurse, and our understanding and experienced caring staff will make sure that your preoperative preparation and postoperative care will go smoothly. In fact, special hygenic techniques and specific care directions will be shown to you by our personnel. Dressings, douches, antiseptic solutions and other necessary medicine related to your surgery will be available on site so you will not have to look for them.
The Residence is opened from 7:00 a.m. to 11:00 p.m. Eastern Time. Every guest is invited to observe basic rules of manners, combined with attention to the convenience of others. Arrangements for someone accompanying are frequently made. However they should be made in advance.
You will find in our Residence warmth, tranquillity and an extraordinary healing start.
Related Links
Vulvas of Transsexual Women:
Yvon Menard and Pierre Brassard http://members.aol.com/tssource/menard.html
Images of post-op male-to-female transsexual vulvae, from patients of Yvon Menard and Pierre Brassard. Images courtesy of Transsexual Women's Resources page, run by Anne Lawrence. http://www.mindspring.com/~alawrence/
Eugene Schrang
125 Forest Avenue, Neenah, WI 54956, USAThe transgender operations are done at Theda Clark Regional Medical Center located in Neenah WI. The town has a population of about 25,000 people and is located about 100 miles north of Milwaukee and thirty miles southwest of Green Bay on Highway 41. The city is covered by air service out of Appleton airport eight miles to the north.
Theda Clark Regional Medical Center is located on the Fox River at Lincoln and First Street and one block from my office at 125 Forest Avenue, just North along First Street and left on Forest Avenue for two blocks.
Requirements
We must have two psychiatric evaluations which specifically recommend GRS or specifically state that you are a candidate for GRS or any sex change procedure such as augmentation mammaplasty. These are to be done by psychiatrists or psychologists who are recognized licensed workers in the gender or sex-oriented field. A letter is required from your endocrinologist outlining the history of your hormone therapy. We strongly recommend and advise that you do not call to schedule your GRS operation until you have completed at least nine months of psychiatric evaluation and understand that the final evaluation for GRS is done by me the day before surgery.
Because we live in an age of high technology, computers, etc, it has unfortunately come to our attention that psychological evaluations can be and have been falsified. Since we have no way of knowing the credentials of every psychologist and psychiatrist who refer patients to us, we must confirm the fact that you are indeed a candidate for GRS. If your evaluations are in doubt, we will have our own Clinical Behavioral Scientist evaluate you on a one time basis either at her office in Chicago for $250.00 or, if it is more convenient for you, at my office here in Neenah for which she charges $500.00. Because this surgery is irreversible, we do not want you to enter into a situation which you will later regret. Dr. Randi Ettner's interview will be on a one time basis and keep in mind that this is necessary for your protection as well as ours. If it so happens that you have had one psychological workup, Dr. Ettner will be asked to evaluate you as a second opinion which may take several sessions or even a complete course of evaluation may be required. In any case, great weight will be placed on her final recommendations.
Very little lab work is necessary which will be done together with an AIDS test at Theda Clark Regional Medical Center the day before the operation. GRS will not be done for anyone who is HIV positive, has herpes or any other venereal disease.
The matter of the overweight patient has come up on a number of occasions. Without having seen you prior to surgery, it is impossible for me to determine the feasibility of doing your surgery if you are markedly overweight. GRS can be done on most people, however in the morbidly obese the operation is virtually impossible and will not be attempted by me. In those individuals who are very overweight but not morbidly obese, the operation is still very difficult and the final results are compromised because of the presence of great amounts of fat tissue. Overweight people simply do not do well during and following surgery and the results of our efforts are not as good as they would be if the person were of normal weight. Some obesity can be dealt with, but I just want to emphasize that anyone over 200 pounds may have a very difficult time. I realize that 200 pounds on someone over 6 feet tall is not a problem, but 200 pounds on someone 5 feet tall is a weight problem very difficult for any surgeon to overcome. The final determination of whether or not your surgery can be performed because of your relative weight, will be determined at the time of your physical examination. If you are markedly overweight, do not be disappointed if your surgery is postponed giving you a chance to lose some excess poundage.
Blood loss is not unusual during or after GRS but blood transfusions are not generally given unless necessary. Should you choose to donate two units of your own blood, which is a very worthwhile idea, they will be administered back to you after the operation. Please contact the blood bank of your local hospital for details and we will do what we can to help in this matter.
Pre-Operative
Much discussion has evolved around the discontinuing of hormone therapy prior to GRS surgery. When the genetic female undergoes routine surgery, nature has provided protective mechanisms, not entirely understood, against the formation of thrombotic emboli, which can cause death, that are not present in the genetic male taking female hormones. Therefore, even though the likelihood of this dreaded eventuality is remote, we strongly recommend for your own safety, that you discontinue taking hormones three weeks prior to and three weeks after your surgery. Withdrawal symptoms are uncomfortable, but temporary, and much better than dying. Also, please stop taking Aspirin as well.
It would be a good idea to bring only the necessities which you will need in the smallest and lightest carrying case you have. This is to prevent tearing of the sutures and damage to the new vagina following surgery. You will spend most of your time in bed and therefore will not need numerous changes of clothes. It is also suggested that you bring only one outfit and wear it both arriving and departing. It is advisable to wear something loose fitting as there will be some tenderness and swelling following surgery. Tight fitting jeans and panty hose may cause discomfort. There is certainly the possibility that there will be some discharge and light bleeding in the genital area after surgery. Although you will be required to use sanitary napkins to absorb the blood, there is a chance some will leak through, therefore dark clothes will help conceal any stains on the return trip. You will need to bring your personal toiletries and a robe if you want to leave your room after you are up and around. The hospital provides gowns which you will be wearing while you are confined to bed. Personal items to entertain you such as cassette players, reading material, are suggested but we strongly recommend that you keep your baggage as light as possible.
As mentioned before, if you have not been evaluated prior to hospital admission, it will be necessary for you to be seen in my office early in the afternoon before the day of surgery. At this time you will be interviewed and undergo a physical examination. You will sign consent forms, have your photograph taken, receive instructions and take care of any remaining financial matters.
If you have never been seen by me, you will be evaluated in my office around one o'clock in the afternoon of the day before your surgery. It would therefore be advisable that you arrive either that morning, or, if you wish, the day prior which would give you an opportunity to get a good night's sleep before you are seen in my office.
The hospital staff is courteous, friendly and competent and although they will be as helpful as possible, any technical questions regarding the surgery are best reserved for me.
It is most important to prepare the patient both inside and out, therefore, you will be given a thorough bowel prep to make the inside body as clean as possible for the operation. You will be asked to take a shower with a shampoo. There will be a perineal and perianal prep which amounts to having these areas of your body shaved. This will be followed by painting the middle part of your body with an antiseptic solution to keep the bacteria count down. A liquid supper is served around 6:00 PM and you will be given a sleeping pill around 10:00 PM.
In the morning, you will be given your pre-operative medication which will make you feel groggy. You will then be taken down to the operating suite where a general anaesthetic will be administered. You will remember nothing until you wake up in the recover room.
Post-Operative
While in the recovery room, we will make every effort to avoid the feeling of nausea and vomiting which we do with both drugs and the administration of oxygen. You will have a Foley catheter in your bladder which may give you a feeling of wanting to urinate. This feeling will pass. Once you are awake, you will be returned to your room where you will sleep for much of the remaining day. The IV in your arm usually stays until you no longer have pain which is about five or six days. Your pain medication, Demerol or Morphine, is given through the IV. Sleeping pills will be given every night that you are in the hospital.
Not counting the day of surgery, you will be confined to bed for six days. For example, if your surgery is one Tuesday, you will not be able to get up and out of bed until the following Monday. Since this may seem like a long time to you, it is best that you bring reading material or paper work to occupy your time.
Constipation is not unusual and you may not have your first bowel movement for three or four days. Of course, it will be necessary for you to use a bed pan as we cannot allow you out of bed until more healing has occurred.
Ice packs will be applied to your groins continuously; your sanitary napkins will be changed as necessary and sponge baths will be given while you are in bed.
You will find a large suture tied over a roll of cotton in your pubic area, this along with your urinary catheter and drains will be removed on the sixth day after which you will take a show or bath. At first you will feel weak but your strength will recover rather quickly.
If urination is difficult, it is because of swelling and the presence of the vaginal pack. Should you be unable to urinate, the catheter will be temporarily replaced.
You will be leaving the hospital on the eighth day. For example, if your surgery was done on Tuesday, you will be discharged on Wednesday of the following week. The day you leave, your vaginal packing will be removed and you will receive instructions how to keep your vagina dilated. If you are sent home on additional drugs, they can be obtained at the hospital pharmacy but be prepared to bring enough money to cover costs.
In order to make your trip home easier and more pleasant, especially if you live far away, we strongly suggest that you stay in one of the area hotels for several days after your hospital discharge.
Monetary Policies
Because we have experienced non-payment of our fees in the past, we have formulated the following fee policy. If you consult with me in my office any time other than the day before your surgery, I charge $75.00 for this time and the $75.00 is to be paid in advance before your consultation is scheduled. To avoid cancellations, "no shows" and people who are not serious, this fee is non-refundable.
The basic fee for the genital surgery is $5,000.00. If your penis is so small as to warrant a skin graft procedure along with the usual inversion technique, there will be an additional $500.00 charge.
Once we set a surgical date, whether or not you have been seen by me in my office, we require a $500.00 deposit to reserve that time. The $500.00 is to be received in our office no later than one week from the date that your surgery is scheduled. Once we set the surgery date and cancel for any reason whatsoever, the $500.00 is absolutely non-refundable. The only exception to this would be if I determine, at the time I first see you in my office, that you are not a candidate for transsexual surgery. Only then will your $500.00 be refunded. Remember the $500.00 advance deposit is to secure your surgical time. If you deposit is not received per our office policy, you may lose your surgery date to someone else.
The remainder of your bill is to be paid by at least two weeks prior to your surgery and <B>no personal checks please.
Hospital and anesthesia fees must likewise be paid in advance. Please have separate cashier's checks made out to each provider in the designated amount. The hospital fee should be made out to Theda Clark Regional Medical Center and the anesthesia fee should be made out to The Association of Hospital Anesthesiologists, Inc.
If procedures are staged, such as orchiectomy followed later by GRS, the inital procedure will be full price. A price break is given for the second procedure; we will reduce the GRS fee by subtracting half the price of the initial procedure. This policy applies only if the initial procedure was done by me. If done by someone else, the full price for the GRS will still be charged.
If more than one operation is done (for example: Genital Transformation plus Augmentation Mammaplasty), it is customary for the surgeon and the anaesthesiologist to cut the cost of the lesser procedure in half. The hospital reduces the second procedure by 25% and the third by 50%. Everyone has discounted their prices well below the standard going rates as a special favour to cosmetic and transsexual patients.
Please remember that all hospital quotations for ancillary cosmetic and transsexual surgery are for one day stay only. There is an additional $80.00 to stay overnight if I feel it is medically necessary for you to be observed for another 12 hours; the charge will increase to $225.00 if you elect to stay overnight for no other reason than it would be a convenience for you. If you remain in the hospital longer than 24 hours, no matter what the reason, your quoted fees will no longer apply and you will be charged a great deal more than those original quotations. Therefore, I suggest you limit the procedures you want to a sensible number. There is a limit to how many different operations I can do on one person at any one time. I will determine how much surgery will be judicious and prudent on a one day stay basis.
All fees are subject to change.
Experience has taught us that insurance does not pay for cosmetic surgery nor Gender Dysphoria problems. There always is, however, that rare exception but since the hassle with insurance companies is so great, we ask that if you have insurance which will cover your procedure, please have this fact noted in writing from your insurance company and we will then, and only then, send what forms you give to us; however, we will still ask for payment in advance and any monies received later and owed to you, will be refunded to you. Lastly, please do not ask this office to send letters to insurance companies trying to convince them that your problem is medically necessary. This is just the hassle we wish to avoid. We suggest that this be done by you in advance of your being seen by me.
Related Links
Surgery Results Pictures
http://host2.mbcomms.net.au/tg/satsg/surgpix.htm Images of various post-operative vulvae, some of which are Dr. Schrang's work. Provided courtesy of the Surgery Options Page.
The Real Life Test: Chapter 13: The Surgery. http://www.primenet.com/~beckster/real13.html#Neenah Personal surgery experience. The story of Becky Allison's transition. Chapter 13 focuses on her surgery with Dr. Schrang in October of 1994.
A Source of Happiness http://www.nu-woman.com:80/happines.htm An essay Dr. Schrang relating to GRS.
Visiting Dr. Schrang: Anne and Jenni go to Neenah http://members.aol.com/tssource/neenah.html Personal surgery experience including images. Jennifer McCloud's surgical experience with Dr. Schrang in June of 1997.
Paper Dolls: Sexual Reassignment in "Paper Valley", Wisconsin http://members.aol.com/tssource/paperdolls.html A detailed description of the GRS procedure performed by Dr. Eugene Schrang in June of 1997 in Neenah, Wisconsin. The article includes several photographs taken in the operating room.
Vulvas of Transsexual Women: Eugene Schrang http://members.aol.com/tssource/schrang.html Images of post-op male-to-female transsexual vulvae, from patients of Eugene Schrang. Images courtesy of Transsexual Women's Resources http://www.mindspring.com/~alawrence/ page, run by Anne Lawrence.
This document was retrieved from the Sex Change Indigo Pages. Page layout and some icons are Copyright ©1996-1998 Perette Barella.
Michel Seghers, Avenue de Broqueville 60, 1200 Brussels, Belgium
Office: +32-2/ 770.01.08, Fax: +32-2/ 770.01.08, Department in hospital: +32-2/ 739.84.05
Requirements for male to female sex reassignment surgery in my department in Brussels, Belgium. I follow the standards of care of the Harry Benjamin Association. Candidate-patients have first to submit the following documents:
Weight: maximum 200 pounds.
After study of these documents, I can quickly give my final decision and propose a date for surgery, but you have to bear in mind that I have a waiting list four months long, starting at approval.
At the present value of the US dollar, the total amount for all bills at the hospital during seven days is equal to $6,000. To that amount, you have to add your airfare and a few days in a hotel, two or three days hotel stay before entering the hospital and three to five days when you leave it before flying home. I can provide information about hotels and about Brussels.
Female hormones must be discontinued two weeks before surgery.
Sex Reassignment Surgeries in Estonia Toomas Kütt and Udo Reino, Tallinn, Estonia +358-9-621 1126 Fax +358-9-621 1107
A private Helsinki medical clinic HSP has begun to arrange sex reassignment surgeries in Tallinn, Estonia. The surgeries are done in a Finnish-owned private clinic in Tallinn. The surgeons, Dr. Toomas Kütt and Dr. Udo Reino, have studied sex reassignment surgery techniques in Italy and United States, and have done several surgeries on Russian and Estonian patients. Technique used is applied penile inversion.
The price is mentioned to be roughly $7500 at the current exchange rate, including travel from Helsinki to Tallinn, hospitalization, surgery, anaesthesia, care etc. HSP provides also services for funding the surgery and scheduling the payment.
The clinic is also planning to begin female to male surgeries, mastectomy, uterectomy and penis construction, later in 1998, under Dr. Pree, who has studied the technique in UK.
L. Von Szalay Frankenfurter Klinik fur Plastische und Wiederherstellung schirurgie, Finkenhofstrasse 15, D-60322 Franfurt/Main, Germany, Office phone: +49 69 - 28 22 88, Fax: +49 69 - 5 96 30 10
For surgery, the office will require you to get a check-up and forward the data to them. Price, including operation, anesthesia, and two weeks at the clinic is approximately $20,000-25,000 depending on the exchange rate.
References
European Journal of Plastic Surgery © Springer-Verlag 1992. Eur J Plast Surg (1992) 15: 192-193.
Jones HW, Schirmer HK, Hoopes JE (1968) A sex conversion operation for males with transsexualism. Scan J Urol Nephrol 14:215-217
Rubin SO (1980) A method of preserving the glans penis as a clitoris in sex conversion operations in
male transsexuals. Scan J Urol Nephrol 14:215-217
Szalay L (1990) Bildung einer Neoklitoris bei Mann-zu-Frau Transsexuellien. Handchir Mikrochir Plast
This document was retrieved from the Sex Change Indigo Pages. Page layout and some icons are Copyright ©1996-1998 Perette Barella.
MTF Reassignment Surgery at Pinderfields Hospital, Wakefield UK
Mr Fenton is a Consultant Plastic Surgeon, who specialises in reconstructive plastic surgery.
Mr Fenton has been performing GRS for at least five years. As well as working for the NHS, he does work privately. The fee for GRS including breast-augmentation is around £7900 inclusive of hospital fees.
I have recently received some information from a patient. She states:
"Everything is fine. It all feels like it's been there forever and I'm very happy with it.
"I've got about 4.5" of depth measuring against my dilator. That's what I've had since surgery, and was done without the need for a skin graft. I expect that, judging by the rather phallic dilators I was supplied with, if I ever acquired a boyfriend and the subject of sex cropped up I wouldn't have any difficulty participating if you see what I mean."
I asked a very personal question, regarding the clitoris.
"It all works and has immense personal entertainment value. The clitoris isn't hooded, but looking at the whole thing now I'm not sure that it's a problem."
Has she had any complications?
"I haven't really had any problems more a few minor niggles that have mostly cleared up as part of the healing process than anything else. One or two things, in particular an annoying granuloma near the clitoris, have cleared up within the last week.
"My waterworks are OK, but not perfect. Rate of flow is acceptable, but direction isn't right yet, it has been a bit of a random spray at times. This is something that has improved over time, and may eventually correct itself and the way other things have healed I think that that is quite possible."
A few months later, she reported: "The urethra is going to need a little trimming. There's also some surplus erectile material, something like "spongiosa" I think he called it, along the path of the urethra, which he's going to have a go at reducing while he's working in the area. It's something that's not particularly a problem, although doing something about it would generally improve the appearance."
MTF Reassignment Surgery at Leicester, UK
Leicester General Hospital and the private hospitals have a Gender Dysphoria Unit which is run principally by Dr. Deenesh Khoosal as a consultant psychiatrist but the surgical input includes Mr Terry as consultant urologist dealing with genital surgery and there are contributions from plastic surgeons, clinical psychologists, speech therapists together with cosmetic advisers.
They have done a number of these operations in Leicester with "good results".
They prefer to manage patients within the NHS if there is funding. The cost in the private sector is kept as low as possible at £4,175. The procedure that is performed in Leicester "compares very well with the one by Dr. Schrang in the USA".
Last Modified 19 Jan 2002