In most cases, the urethra can be lengthened so that the patient can urinate whilst standing.<\/td> Due to the complexity of the operation, the recovery process takes longer than with metoidioplasty.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\nAn alternative method is the clitoris-penis reconstruction. In this procedure, the clitoris \u2013 which has been enlarged by hormone therapy \u2013 is used and reshaped into a smaller penis. This technique, also known as metoidioplasty, is less invasive; however, the penis remains smaller than with phalloplasty.<\/p>\n\n\n\nAdvantages<\/th> Disadvantages<\/th><\/tr><\/thead> As the procedure is carried out on the enlarged clitoris, sensitivity is largely preserved.<\/td> The resulting penis is usually smaller and, for many people, not large enough for penetrative sex.<\/td><\/tr> The operation is less complex and takes less time than a phalloplasty.<\/td> It is not always possible to lengthen the urethra, so it may not be possible to urinate whilst standing.<\/td><\/tr> No large skin grafts from other parts of the body are required, which minimises scarring.<\/td> <\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\nComplications associated with phalloplasty<\/h4>\n\n\n\n Phalloplasty carries a risk of complications such as fistulae (abnormal connections between organs), urethral strictures (narrowing of the urethra), or problems with implants used to achieve erections.<\/p>\n\n\n\nMale to Female (MtF)<\/h3>\n\n\n\n In the case of gender reassignment from male to female, a plastic surgeon can perform the Breast surgery<\/strong> as well as a Vaginal reconstruction (colpoese)<\/strong> a procedure in which an artificial vagina (neovagina) is created from existing body tissue. A distinction is made between the following variants:<\/p>\n\n\n\nThe Penile inversion vaginoplasty (PIV)<\/strong> is regarded as the standard procedure. In this procedure, the skin of the penis is turned inside out and used to form the vaginal canal. The glans is often used to form a clitoris, to enable sexual sensation. The labia are formed from other parts of the skin of the penis or scrotum.<\/p>\n\n\n\nAdvantages<\/th> Disadvantages<\/th><\/tr><\/thead> Good functional and aesthetic results.<\/td> If there is insufficient skin available, the vaginal canal may be shallower.<\/td><\/tr> The clitoris may be sensitive.<\/td> Regular bougienage (dilation) is necessary to keep the vagina open.<\/td><\/tr> A widely used and tried-and-tested method.<\/td> <\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\nThe second option is the Sigmoid colon vaginoplasty<\/strong>. With this technique, part of the Sigmoids<\/strong> (a section of the large intestine) is used to create the vagina. This method is often used when there is not enough skin available from the penis or scrotum.<\/p>\n\n\n\nAdvantages<\/th> Disadvantages<\/th><\/tr><\/thead> Enables a deeper vaginal canal.<\/td> A more complex surgical procedure with a higher risk of complications, as it involves the bowel.<\/td><\/tr> The intestinal lining provides natural lubrication.<\/td> Possible post-operative complications, such as infections or scarring.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\nFacial feminisation surgery is also frequently carried out, sometimes referred to as \u2018combined surgery\u2019 for transgender women, and often includes the following procedures:<\/p>\n\n\n\n
\nBrow and lip lift, lipofilling<\/li>\n\n\n\n Jaw and chin correction<\/li>\n\n\n\n Sanding down the Adam\u2019s apple<\/li>\n\n\n\n Facelift<\/li>\n\n\n\n Eyelid surgery<\/li>\n\n\n\n Reconstruction of the forehead<\/li>\n\n\n\n Receding hairline<\/li>\n<\/ul>\n\n\n\nIn addition to the Oestrogen therapy<\/strong> There are also some trans women who decide to undertake voice training as well, in order to work on achieving a more feminine or higher-pitched voice.<\/p>\n\n\n\nHow does a male-to-female gender reassignment work?<\/h4>\n\n\n\n Gender reassignment to become a woman is characterised in particular by the Vaginoplasty<\/strong> in which an artificial vagina is formed from the shaft of the penis. Tissue from the penis and scrotum is used to create a vagina, vulva and clitoris. The urethra is often shortened and the vaginal canal created.<\/p>\n\n\n\nIn addition, regular Bougiering<\/strong> necessary following gender reassignment surgery. This involves the insertion of a medical instrument (bougie) to maintain the depth and width of the newly formed vagina after the operation and to keep the tissue supple. Bougie dilation is an essential part of aftercare to prevent the new vagina from narrowing or closing up. Some patients report that this process can be quite painful, which is why regular consultation with a specialist or surgeon may be advisable to prevent injury or inflammation.<\/p>\n\n\n\nComplications associated with vaginoplasty<\/h5>\n\n\n\n With penile inversion vaginoplasty, there is a risk that the artificially created vagina may narrow or collapse following genital surgery. Regular bougienage (stretching) is necessary to maintain its shape and function.<\/p>\n\n\n\nGender reassignment: How long does the procedure take and what are the risks?<\/h2>\n\n\n\n Two of the most common questions asked by patients relate to the duration and the associated risks of gender reassignment surgery. In particular, it is important for many people to know how long the recovery periods will be after the procedures, as these may clash with personal commitments and working hours. As gender-affirming surgery often involves several major procedures, thorough and personalised medical advice is essential.<\/p>\n\n\n\n
How long does gender reassignment take?<\/h3>\n\n\n\n The process of gender reassignment often begins years before the actual operation. This includes the process of self-discovery, which for many trans people can be a stressful and protracted process due to social stigma, as well as undergoing (hormone) therapy, medical care and psychological assessments. The duration of gender-affirming surgery in specialist clinics naturally depends on the type and number of procedures involved. Generally speaking, however, most gender reassignment operations take several hours due to their complexity.<\/p>\n\n\n\n
How long do you have to stay in hospital after gender reassignment surgery, and when can you get back to your normal life?<\/h3>\n\n\n\n This is a difficult question to which there is no one-size-fits-all answer. According to a Vaginoplasty<\/strong> The hospital stay usually lasts 7 to 10 days<\/strong>. In the case of a Phalloplasty<\/strong> or Metoidioplasty<\/strong> the hospital stay may last between 10 and 14 days<\/strong> take longer, as these procedures are often more complex and involve larger skin grafts.<\/p>\n\n\n\nAfter being discharged from hospital, it is necessary to stay at home for at least 4 to 6 weeks<\/strong> to take it easy. During this time, physical exertion such as heavy lifting, sport and sexual activity should be avoided.<\/p>\n\n\n\nWhat risks need to be taken into account in general?<\/h3>\n\n\n\n As with all medical and cosmetic procedures, gender-affirming surgery also carries risks. For example, following the operation \u2013 whether male-to-female or vice versa \u2013 infections, scarring, bleeding and bruising, or even thrombosis and embolism, may occur. Furthermore, transgender surgery may result in a complete or partial loss of sensation in the operated area. This can affect sexual sensation, but also everyday sensations.<\/p>\n\n\n\n
Costs, health insurance, insurance schemes: Who pays for gender reassignment?<\/h2>\n\n\n\n The cost of gender-affirming surgery is a subject that often causes stress and anxiety for patients. As with other plastic surgery procedures, patients often have to pay for and finance the operations themselves. Depending on the type and complexity of the procedure, operations can cost between 15,000 and 60,000 euros. This is why many people ask: Does health insurance cover gender reassignment surgery?<\/p>\n\n\n\n
The answer: Yes, under certain conditions.<\/p>\n\n\n\n
\nDiagnosis of gender dysphoria by a specialist or psychotherapist<\/li>\n\n\n\n Long-term treatment to officially confirm trans identity<\/li>\n\n\n\n A real-life trial lasting at least 12 months, during which the individual is to test living in their intended gender role<\/li>\n\n\n\n Medically supervised hormone therapy lasting 12 months or longer<\/li>\n\n\n\n Reports by two independent experts to determine whether gender reassignment is medically necessary<\/li>\n<\/ul>\n\n\n\nOnce these conditions have been met, a Application for reimbursement of costs<\/strong> can be applied for through the health insurance fund. If the application is approved, certain treatments may be covered, for example:<\/p>\n\n\n\n\nCosts of psychological support<\/li>\n\n\n\n Costs for the Hormone therapy<\/strong><\/li>\n\n\n\nCosts of surgical procedures (e.g. vaginoplasty, phalloplasty, breast surgery)<\/li>\n\n\n\n Aftercare and any necessary Corrective surgery<\/strong><\/li>\n\n\n\nCosmetic procedures<\/strong> (e.g. hair removal, vocal cord surgery)<\/li>\n<\/ul>\n\n\n\nWhen it comes to gender-affirming surgery, persuading your health insurance provider to cover the costs can be a lengthy and exhausting process. Furthermore, decisions on which treatments and procedures will be covered are made on a case-by-case basis. Patients are therefore advised to seek professional advice in advance to ensure that all the requirements for health insurance-funded transgender surgery are met.<\/p>\n\n\n\n
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Important note<\/strong><\/p>\n\nEvery health insurance provider has different procedures and conditions, so it is advisable to contact your health insurance provider at an early stage and submit all the necessary documents. Private health insurance policies may also have different rules.<\/p>\n<\/div>\n\n\n\n
Insurance cover for gender reassignment and plastic surgery<\/h3>\n\n\n\n For people planning gender reassignment surgery, it may be worth taking out a specific insurance policy to cover the procedure. These policies often cover not only the Operation<\/strong> not only on their own, but also potential complications<\/strong>, Follow-up treatments<\/strong> and necessary follow-up procedures<\/strong>. The main advantage of this sort of cover lies in the financial security it provides: particularly in the case of complex procedures such as gender reassignment surgery, unforeseen costs and follow-up treatment may arise which the health insurance provider may not cover and which would be difficult to manage without insurance.<\/p>\n\n\n\n