Current concepts in gender affirmation surgery

People with gender dysphoria have persistent discomfort with their anatomical sex. They are diagnosed according to the criteria proposed by DSM-5. Guidelines for persons with gender dysphoria are periodically published by the World Professional Association for Transgender Health (WPATH), as Standards of Care (SOC). Once mental health professional through their assessment have reached to a conclusion of Gender dysphoria, further procedures for gender affirmation are started. Next in sequence is real-life experience of at least 12 months under strict observation of mental health professional to justify affirmation surgery. Following real life experience, hormone therapy is started under supervision of an endocrinologist. The surgeries done to establish their anatomical sex in accordance to their psychological sex are called gender affirmation surgeries (GAS). Not all people with gender dysphoria undergo GAS and among all of those who undergo gender affirmative surgery, only few undergo all surgical procedures depending on the severity of gender dysphoria. Genital and non-genital surgeries are done for both female to male and male to female conversions. After discussion with the patient, staged surgeries are done. Multidisciplinary approach with good communication in between the health professionals gives the best results. Even in 21st century, people with gender dysphoria are still discriminated, looked upon differently and are not accepted as they are in the society. We, as health professionals should provide the highest standards of care with the best possible options to restore their dignity and to improve their acceptance in the society. This article discusses the current concepts in GAS.