What is sex reassignment surgery?
Sex reassignment surgery (SRS) is a range of procedures that alter a person's physical characteristics to match their gender identity. This form of gender-affirming care is a crucial step in the medical transition process for transgender people, marking a public and personal confirmation of their identity.
SRS can include procedures that modify:
- facial features;
- reproductive organs;
- secondary sexual characteristics.
A patient’s sex reassignment surgery may include a single or several medical procedures. The number of surgeries a transgender person undergoes depends on their personal goals and wishes, as well as doctors’ medical advice.
You may also hear sex reassignment surgery called:
- gender-affirming surgery;
- gender-confirming surgery;
- gender reassignment surgery.
What is gender-affirming care?
Gender-affirming care is a holistic approach to healthcare that recognizes and supports an individual's gender identity, especially within the transgender community. This type of care encompasses a wide range of medical, psychological, and social services. Key components include:
- hormone therapy;
- surgical interventions (SRS);
- mental health support;
- voice therapy;
- social support services.
Gender-affirming care aims to improve the well-being and quality of life of transgender people by addressing their specific health needs and reducing gender dysphoria.
What is a gender clinic?
Gender clinics, or sex change hospitals, offer specialized healthcare services for transgender, nonbinary, and gender-diverse individuals. They administer medical and surgical interventions to help patients transition to their identified gender.
What types of sex reassignment surgery do gender clinics provide for patients globally?
Bookimed partners with over 40 gender-affirming clinics worldwide, offering access to expert care and a supportive environment for your transition journey. Global gender clinics provide a variety of surgeries for those who desire to match their bodies with their gender identities.
Bottom Surgery
Also known as genital reconstructive surgery, this medical procedure aims to match the physical appearance and functionality of a patient's genitalia with their identified gender.
For male-to-female (MTF) transition, gender confirmation clinics offer the following options:
👉 Learn more about MTF bottom surgery here.
Available bottom surgeries for female-to-male (MTF) transition include:
- phalloplasty — constructing a penis from other body tissues;
- metoidioplasty — forming a smaller penis from existing genital tissue.
👉 Read our guide to MTF bottom surgery.
Top Surgery
Top surgery enhances the feminine or masculine characteristics of the patient’s chest. Depending on the gender that the patient is transitioning to, sex change hospitals can employ one of the following techniques:
- MTF top surgery. Breast augmentation using implants for a more feminine chest.
- FTM top surgery. Mastectomy and chest contouring for a flatter, more masculine chest appearance.
👉 Learn more about how top surgery works.
Facial Reconstructive Surgery
At gender-affirming clinics, surgeons often perform operations to modify facial features for a more feminine or masculine appearance. Approaches include:
👉 Learn what you need to know about FFS and FMS.
Voice Surgery
This type of surgery modifies patients’ vocal pitch — raising it for MTF transitions and lowering it for FTM transitions. Sex change hospitals often pair this procedure with voice therapy to help patients harmonize their voices with their authentic selves.
How much is transgender surgery?
Globally, the cost of gender-affirming surgery can range from $5,000 to $75,000, depending on the specific procedure, country, and hospital.
- In the US, costs are the highest, ranging between $25,000 and $75,000 on average (reach up to $134,000 for FTM bottom surgery).
- In the UK, prices fall between $10,000 and $75,000.
- Turkey presents the most affordable options, with sex change operations costing from $5,000 to $15,000.
- In Thailand, costs vary between $10,000 and $22,000.
- In Mexico, prices start at $9,500.
👉 Read our detailed guide on transgender surgery costs.
Is gender-affirming surgery covered by insurance?
Coverage for gender-affirming surgery varies by health insurance policy and provider. In regions with progressive health policies, many insurance plans do provide for these surgeries. However, the extent of coverage can differ significantly. Insurance plans usually do not cover gender-affirming procedures deemed solely cosmetic. Most insurance companies will request documentation, like letters of readiness or proof of persistent gender dysphoria.
What is the best country for gender reassignment surgery?
The best countries for gender reassignment surgery abroad are Thailand and Turkey. These countries provide faster access to experienced surgeons and inclusive care, while the U.S. is hindered by high costs (reaching up to $75,000) and regional disparities in transgender healthcare.
Thailand
Thailand is the global leader in gender reassignment surgery, with a history spanning over 50 years.
👍Pros:
- Expertise and experience. Thailand's reputation as a pioneer in gender-affirming surgery is unparalleled. The country is the №1 global destination for gender confirmation due to its medical professionals' expertise and welcoming approach to transgender individuals.
- Cost-effectiveness. Gender-affirming surgery in Thailand is 3 times more affordable than in the U.S.
- Cultural sensitivity. Thailand's culture is very accepting of transgender people. There is a visible presence of kathoeys (transgender women) among the country's models, singers, and movie stars.
👎Cons:
- Distance and travel. The travel distance can be a hurdle, increasing costs and logistical planning.
Turkey
Turkey has emerged as a top contender in gender reassignment surgery due to its rapidly growing medical tourism sector.
👍Pros:
- Rising medical tourism destination. Turkey is experiencing a medical tourism boom, welcoming over 1 million visitors and beating its own records each year. Due to its investment in healthcare infrastructure and medical technology, Turkey is becoming a central hub for various medical procedures, including gender-affirming surgery.
- Quality at competitive prices. Turkey offers a balance of high-quality medical care with prices that are 2-3 times lower than in the U.S. or Europe.
- Strategic location. Its geographical position makes Turkey a convenient option for patients from Europe, Asia, and the Middle East.
👎Cons:
- Cultural and legal climate. While Turkey’s gender clinics are progressive, the broader societal and legal recognition of transgender rights in Turkey varies. This might affect the overall experience.
What is the best hospital for gender reassignment surgery?
For a luxurious experience with Thailand’s #1 gender-affirming surgeon:
💰 Cost: $10,000 (includes bottom surgery, general anesthesia, medications, consultations, and transfers).
🌟 Why it's a top choice:
- Led by Dr. Pichet Rodchareon, Thailand’s leading gender-affirming surgeon with over 30 years of experience and 3,000+ successful surgeries. Dr. Pichet is a member of the International Society of Aesthetic Plastic Surgery (ISAPS) and the World Professional Association for Transgender Health (WPATH).
- The hospital specializes in scrotal skin graft vaginoplasty, top surgery, facial feminization, and body sculpting—full spectrum of care for transgender patients.
- Patients enjoy private, hotel-style rooms with 24-hour in-room attendants, perfect for those traveling alone. The multilingual medical team helps international patients with convenient communication.
For a highly specialized urology-focused approach:
💰 Cost: $11,000 (includes bottom surgery, 5-star hotel accommodation, airport-hotel-clinic transfers).
🌟 Why it’s a top choice:
- This clinic specializes in urology and sexology and provides targeted care for gender reassignment.
- Dr. Baris Nuhoglu, with 27 years of experience, has performed over 2,000 surgeries, helping patients achieve life-changing physical and functional transformations.
- A respected professor and researcher, Dr. Nuhoglu is an active member of the European Association of Urology, Turkish Urology Association, and Endourology Society.
How to choose the best hospital for gender reassignment surgery?
🏅 Accreditation and credentials. Look for sex change hospitals accredited by reputable health organizations. Accreditation ensures the hospital meets high standards of care and safety.
🩺 Experienced surgeons. Research the doctors' experience and qualifications. Look for specialists who have performed a significant number of gender-affirming surgeries and have a proven track record of success.
📝 Patient reviews. Seek out feedback from former patients to receive insight into the gender clinic’s quality of care and patients’ satisfaction with gender-affirming procedures.
✅ Comprehensive care approach. Choose a sex change hospital that offers a holistic approach to gender-affirming care, including pre-surgery counseling, post-operative support, and follow-up care.
📷 Before-and-after photos. Request to see before-and-after photos of previous surgeries performed by the gender surgeons. This will give you an idea of their skill level and the results you might expect.
🤝 Consultation process. It is crucial to have a thorough and informative consultation process before deciding where to get a sex change. The best sex change hospitals will make you feel heard, respected, and comfortable asking questions about the procedure, risks, and expected outcomes.
How long do I need to stay in the country for gender reassignment surgery?
⏳Hospital stay: 3-7 days. For most sex change operations, you'll likely need a hospital stay ranging from 3 to 7 days. This period allows your surgical team to conduct the necessary medical exams, perform the procedure, monitor your initial recovery, manage any pain, and prevent complications.
⏳Stay in the country: 13-14 days. After leaving the sex change hospital, you will have to stay in the country for about 13 to 14 days. This extended stay ensures you have access to your surgeon for follow-up appointments, where they can assess your healing, address any concerns, and guide you through the early stages of post-operative care.
How long is the recovery from transgender surgery?
On average, you will be able to resume your usual activities 4-8 weeks post-surgery. However, the recovery period largely depends on the type of gender-affirming surgery:
- Top surgery. Within 1-2 weeks, you may notice a decrease in swelling and discomfort. Steer clear of any strenuous activity for at least 1 month after breast augmentation or mastectomy.
- Bottom surgery. Usual activities can be resumed after 6 weeks, though follow-up visits will continue for a few months. Avoid sexual activities for 6 weeks post-phalloplasty and 12 weeks post-vaginoplasty.
- Facial feminization/masculinization. Initial swelling reduces within 2-4 weeks after facial reconstructive surgery, but complete healing can take up to 4 months.
- Voice surgery. Recovery is about 3 weeks and requires absolute voice rest for the first 7 days.
How old do you have to be to get gender reassignment surgery?
The general requirement is that transgender patients must be at least 18 years old to undergo gender-affirming procedures. However, there are exceptions where younger people can access hormone therapy or surgery with parental consent and a comprehensive evaluation.
- Europe. Patients must generally be 18 to have gender reassignment surgery without parental or public authority consent. Exceptions include Slovenia (15), Scotland (16), and England (17).
- United States. The U.S. has a mixed legal stance, with 22 states banning gender-affirming surgery for minors.
What are the risks and side effects of gender reassignment surgery?
Gender-affirmation surgery, like any surgical procedure, carries potential risks and side effects. These may include:
- altered sensation;
- difficulty emptying the bladder;
- tissue necrosis;
- narrowing of the new vagina or urethra;
- scarring and delayed healing;
General surgery risks may also arise, such as:
- side effects of anesthesia;
- bleeding;
- clot formation;
- infections.
❗The chance of these risks is low in the hands of experienced surgeons. A study by the American Society of Plastic Surgeons suggests that 99.7% of trans people are satisfied with the surgery's outcome. If the complications do arise, they are usually treatable with proper medical care and follow-up. Moreover, you can undergo revision surgeries to correct issues or if you are not fully satisfied with the results.
✅ Choosing a reputable clinic and an experienced surgeon is the best way to protect yourself from complications. Bookimed can provide access to top-rated clinics and surgeons worldwide. Our platform offers verified patient reviews, expert consultations, and assistance in finding the best place to get gender reassignment surgery.
Is bottom surgery reversible?
Bottom surgery is designed to permanently change the body to align with a person's gender identity. Undoing these changes would require complex and extensive surgical intervention, which may not fully restore the original anatomy or function. Therefore, it's crucial to have a clear understanding of potential outcomes and be certain of your decision before proceeding.
How to get gender-affirming surgery with Bookimed?
💚Submit a request. Start by filling out a request on the Bookimed website. Provide details about your desired surgery and any specific preferences you have.
💚Consult with a Bookimed Manager. Our manager will contact you to discuss your needs, answer questions, and provide you with options.
💚Choose the perfect country and hospital. Based on your preferences and needs, your Bookimed manager will recommend the best countries and clinics specializing in gender-affirming surgery. They'll help you weigh the pros and cons to make an informed decision.
💚Receive a personalized cost estimate. Once you've chosen where to get transgender surgery, Bookimed will provide you with a customized cost estimate for your surgery.
💚Schedule your trip. Bookimed will help you schedule the surgery and plan your trip to the chosen sex change hospital, ensuring a smooth and stress-free experience.
Resources
- Johns Hopkins Medicine. Gender Affirmation Surgeries. www.hopkinsmedicine.org/health/wellness-and-prevention/gender-affirmation-surgeries
- Healthdirect. (2024). Gender affirming surgery. https://www.healthdirect.gov.au/gender-affirming-surgery
- Journal of General Internal Medicine. (2021). Identifying and Addressing Barriers to Transgender Healthcare: Where We Are and What We Need to Do About It. https://pmc.ncbi.nlm.nih.gov/articles/PMC8606364/
- BBC. (2024). Life on an NHS transgender waiting list. www.bbc.com/news/uk-england-68588724
- European Union Agency for Fundamental Rights. Access to sex reassignment surgery. https://fra.europa.eu/en/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-sex-reassignment-surgery
- Bloomberg. (2015). How Thailand Became a Global Gender-Change Destination. https://www.bloomberg.com/news/features/2015-10-26/how-thailand-became-a-global-gender-change-destination
- Human Rights Campaign. Map: Attacks on Gender Affirming Care by State. https://www.hrc.org/resources/attacks-on-gender-affirming-care-by-state-map
- Plastic and Reconstructive Surgery. (2023). Regret after Gender-Affirming Surgery: A Multidisciplinary Approach to a Multifaceted Patient Experience. https://pubmed.ncbi.nlm.nih.gov/36727823/