Gender Affirmation Surgery in Melbourne

Gender Surgery in Melbourne with Dr Patrick Briggs Plastic Surgeon

Gender affirmation surgery, also known as gender confirmation surgery or transgender surgery (previously known as gender reassignment surgery) is now offered in Victoria by Specialist Plastic Surgeon and Melbourne Gender Surgeon Dr Patrick Briggs. Previously based in Perth WA, Dr Briggs has recently relocated his practice to Melbourne.

What is Gender Dysphoria?

Gender dysphoria refers to the condition where an individual feels that both their psychological and emotional identity does not match their birth gender. Even though it can cause serious emotional pain, distress and anxiety, gender dysphoria is not a mental illness.

However, that’s not to say it does not affect your mental health. Stress that builds as a result of feeling different, homophobic or transphobic attitudes from others and trauma for bullies or alienation from family and friends can all contribute to a decline in mental health.

In 2007 Australian Research Centre in Sex, Health & Society published ‘Tranznation: A report on the health and well being of sex and gender diverse (Trans) gender people in Australia and New Zealand’ the publication shared the following statistics;

• Nearly one in five (18.6%) had experienced a physical attack or other kinds of violence
• A large majority of trans people (87.4 %) had experienced at least one form of stigma or discrimination
• Over half (53.4%) reported verbal abuse
• One third (33.6%) had received threats of violence or intimidation

What is Gender Affirmation Surgery?

Gender Affirmation Surgery refers to life-changing surgical procedures in which a surgeon changes both a patient’s physical and sexual characteristics. It is commonly chosen by transgender males, females and Non-binary individuals.  It is often used to help treat gender dysphoria.

There are several different Gender affirmation Surgeries, including

Top surgery

As the name suggests, top surgery refers to the surgical procedure done on the top part of the body, i.e. chest or breasts.

• FTM (Female to Male) Top surgery removes the breast tissue from the chest to make the chest look more masculine.
• While MTF (Male to Female) Top surgery is a breast reconstruction procedure that uses breast implants to help enhance feminine breast features.

Feminisation Surgeries

• Male to Female Top Surgery (breast augmentation mammoplasty)
• Adams Apple Reduction Surgery by Dr Stephen Kleid FRACS ENT Surgeon
• Orchiectomy (not offered by Coco Ruby Surgeons)
• Vaginoplasty (not offered by Coco Ruby Surgeons)
• Facial feminisation surgery (not offered by Coco Ruby Surgeons)
• Other Plastic Surgery for Women

Masculinisation Surgeries

• Female to Male Top Surgery (chest masculinisation surgery)
• Scrotoplasty (not offered by Coco Ruby Surgeons)
• Hysterectomy or chest sculpting with implants (not offered by Coco Ruby Surgeons)
• Other Plastic Surgery for Men

Male to Female (MTF) or Male to Nonbinary (MTN) Top Surgery

This surgery involves the implantation of saline or silicone implants to increase chest size and contour the shape to achieve a more feminine appearance. Transgender Breast Augmentation, feminizing breast surgery and breast mammoplasty are all alternative names for this procedure.

Female to Male (FTM) or Female to Nonbinary (FTN) Transgender Top Surgery

This procedure is a reconstructive surgical procedure that involves the removal and contouring of breast/chest tissue to create a flat, more masculine appearance. Alternative names for this procedure include both masculinising chest surgery and/or subcutaneous mastectomy. The procedure can help treat gender dysphoria.

Hormone Therapy

Hormone therapy is another part of the Gender affirmation/confirmation process. Whether transitioning from;

• Male to female (MTF) or nonbinary (MTN)
• Or, female to male (FTM) or nonbinary (FTN).

Hormone therapy commonly includes either;

1. Testosterone therapy.

Testosterone helps to suppress feminizing characteristics and induce masculine features, often used when an individual is transitioning from FTM or FTN.

2. Estrogen therapy.

Estrogen helps to enhance feminizing characteristics, it is often combined with antiandrogens to suppress masculine features. This is commonly used when an individual is transitioning from MTF or MTN.

While not all transgender individuals choose to undergo hormone therapy, it can be medically necessary for those who wish to physically transition. In other words, you could potentially claim some of the costs thru medicare.

Hormone therapy is not a necessity before top surgery. However, in some transgender men/nonbinary individuals, hormone therapy can help increase breast tissue before breast augmentation. While hormone therapy pre-surgery can help give the individual a better outcome post-surgery it is not a necessity. Doctors will often test patients hormone levels before surgery to ensure they are within the targeted range.

Your Patient Journey for Top Surgery Melbourne

Consultation with Dr Briggs

Before you undergo top surgery, you will need to have a thorough consultation with your surgeon to fulfil certain prerequisites. Your doctor will screen and diagnose your mental and physical health status and ask if you have any medical comorbidities (Comorbidity is defined as the co-occurrence of mental and physical disorders within the same person, regardless of the chronological order in which they occurred or the causal pathway linking them). Your consult will also include:

• An evaluation of both your personal and family medical history
• A general physical examination that includes;
  • Reproductive system assessment
  • Cardiac system assessment
  • Respiratory system assessment
  • And, gastrointestinal system assessment.
• Various lab investigations of your blood, urine, or X rays.

Along with physical assessment, your doctor will also require a mental health examination. That will include;

• Your gender identity and dysphoria.
• How your gender identity has made an effect on your school, home, office, and all your friends and family.
• As well as, mood issues

Consent for Gender Affirmation Surgery

After discussing all the risks, complications and conditions with your doctor, you must give informed consent that includes:

• Risks and benefits
• Expense
• Alternative method
• Social and legal implications
• Complications
• And irreversibility of the procedure

If you are nervous or unsure of the procedure, you can always talk with fellow transgender people who have undergone similar procedures. You may also want to take your time deciding if the surgery is the right choice for you.

Recovery and Results after Gender Affirmation Surgery

After the surgery, your surgeon will wrap and compress your chest and must stay this way for several weeks. Drains are kept under the site where your breast tissue was removed.  The function of the drains is to remove fluid or blood that accumulates after surgery. Some additional precautions you must take after the procedure include:

• Sleeping with your body/torso elevated for a few weeks after the surgery.
• Take everything your doctor tells you about recovery seriously
• Follow their instructions to the letter
• Avoid heavy chest exercises for 2 to 3 months post-surgery.
• Be aware that you may need additional surgery to improve your chest size or shape.
• If you choose, follow up your surgery with further hormone replacement therapy.

Visit the Gender Affirmation Surgery Photo Gallery

Funding Your Gender Surgery

• How do you pay for gender affirmation surgery?

  • FTM Top Surgery may be covered by Medicare and Private Health if you meet the strict criteria.
  • Read the BLOG Does Medicare Cover Gender Affirmation Surgery?
  • Since your insurance may not always cover gender surgery, there are a variety of options to help you pay for surgery. For example Personal loan, Credit cards, Medical Finance and Payment plans,  Family loan or  Crowdfunding and fundraising

Choosing the Best Surgeon for Gender Surgery in Australia

There are huge differences between cosmetic surgeons and plastic surgeons concerning their education, training, qualifications, operating rights and more.

Dr Patrick Briggs is a highly knowledgeable plastic surgery expert and a Fellow of the Royal College of Surgeons (Ireland). He is a member of ISAPS, ASAPS and ASPS, all of which are protected medical titles and ensure a certain (minimum) level of expertise and experience. Moreover, he is a specialist plastic surgeon that is qualified to operate in accredited hospitals around Australia.

Why Choose Dr Patrick Briggs – Specialist Plastic Surgeon?

Dr Patrick Briggs is a highly skilled and well-trained Specialist Plastic Surgeon with experience in all fields of plastic and cosmetic surgery. Furthermore, he has been working in the field of cosmetic and plastic surgery for over 20 years and specialised in breast procedures. He performs surgeries with extreme precision and up-to-date approaches. Book a consultation now to begin your journey.

Gender Reassignment Surgery is a surgical procedure that changes primary sexual characteristics. At CocoRuby Plastic Surgery, Dr Patrick Briggs, a Specialist Plastic Surgeon (FRCS, FRCSI, FRCSI (Plast. Surg)) performs gender confirmation surgery. Dr Briggs has over 20 years of experience and is well known for his up-to-date approach to gender surgery.

If you feel that you need to change your body, your intimate parts, your perceived gender, or if you have Gender Dysphoria, this may be the answer for you. Other names for this life-changing surgical procedure include; Gender Affirmation, Gender Adjustment, or Gender Confirmation Surgery.

Some Frequently Asked Questions About Gender Affirmation Surgery

Is gender affirmation surgery painful?

• You will be under general anaesthesia for your surgery. In other words, you won’t feel any pain during the procedure. However, it is a highly complex surgery and some discomfort during recovery is normal.

Is gender affirmation surgery considered cosmetic?

• Unfortunately, even though gender affirmation surgery is done to help manage gender dysphoria, it is considered cosmetic, it is only deemed medically necessary if it meets certain conditions.

What is the youngest age you can have gender surgery?

• If you are over 16 years of age and you get legal approval you can undergo Gender affirmation surgery.

Do you get scars after FTM or MTF top surgery?

• Yes, both MTF and FTM surgery results in some degree of scarring. But scars will gradually fade and flatten over time. Most patients have felt their final results are well worth the scars in the beginning

How do I know which type of top surgery is best for me?

• Your surgeon will give you the best professional advice before the procedure. The procedure depends upon your chest size, shape, skin elasticity, your preferences for nipple and areola size and placements

Do I need to take testosterone before I get FTM top surgery?

• You do not need testosterone therapy before FTM top surgery. But the testosterone will help develop chest muscle and body hair. While this can improve the aesthetic surgery results, it is not necessary.

How long does the top surgery take?

• It depends on the procedure and the surgeon. Generally speaking, it may take between 1 hour and 3 hours.

Can breasts grow back after top surgery?

• Although a little tissue is left behind to maintain the contour of the chest, 95% of the tissue is removed so, breast tissue will not grow back

Will I need multiple surgeries for the top surgery?

• Most patients only require a single surgery however <5% will have to undergo additional revisionary surgery which is usually a very minimal procedure.

When can I resume my daily work activities after top surgery?

• You can leave the hospital the next day after surgery but you can only resume your office job after 2 to 3 weeks.
• We also recommend avoiding heavy chest work for 2 to 3 months.

Gender Dysphoria FAQs

What does dysphoria feel like?

• People that suffer from Dysphoria or gender dysphoria feel it differently.
• While you may experience sadness, emptiness and dissatisfaction, you may also feel anger, frustration and negativity around your body.
• The most prevalent feeling is that of negativity towards your body.

What does FTM dysphoria feel like?

• FTM stands for Female to Male
• FTM dysphoria can manifest itself as feelings of anger, frustration, dissatisfaction and in some cases, even shyness about your own body and the genital region.
• It is important to notice that different people experience FTM gender dysphoria differently.

How do you know if you are nonbinary?

• If you feel that the expressions such as male/female, man/woman, masculine/feminine do not apply to you and do not fully express how you feel about your own body and gender, you may be non-binary.
• If you need any assistance or guidance in understanding how you feel, you may contact Gender Diverse Centres and seek understanding and advice from like-minded people.

What are the signs of gender dysphoria?

• You may have gender dysphoria if you:
  • Feel that your desired gender does not match your biological characteristics,
  • Feel the need to hide your body
  • Present yourself in ways that would not reveal your biological sex or
  • Show your body contrary to your physiology.

Can puberty cause gender dysphoria?

• Gender dysphoria may be revealed during puberty.
• Most people, however, understand that their notion of gender is diverse from their early childhood.
• That being said, some people may experience gender dysphoria much later in life.

Can you develop gender dysphoria?

• Yes, you can develop gender dysphoria.
• As you age, you may experience a mismatch between your gender and how you feel about it.
• In general, there is no upper age limit as to when you may experience gender dysphoria, although the older you get, the lower the chances of gender dysphoria occurring.

Can gender dysphoria develop later in life?

• Yes, gender dysphoria can develop later in life.
• However, many people state that they had gender dysphoria related feelings from earlier stages of life but have been hiding them to avoid stigma.

Can gender dysphoria be a phase?

• Gender dysphoria is generally not a phase.
• It is a psychological condition that may develop and persist throughout life.
• It is different from stages in sexual maturation, such as autoerotic, homoerotic and heteroerotic phases, when individuals are attracted to themselves, persons of the same and opposite gender, respectively.

Can gender dysphoria go away?

• Studies have found that early-stage gender dysphoria may go away.
• However, if gender dysphoria persists through puberty, it is most likely going to be permanent.

What is the process of changing from male to female?

• Changing from male to female encompasses three distinct phases:

1. Psychological counselling
   • trying to understand where the need to change one’s gender comes from and whether the desire is authentic or not,
2. Hormone therapy
   • Although not always a prerequisite-induces changes in one’s body that may give the recipient a better idea of what living in the body of the opposite sex is like and aids with the procedure later on.
   • You may experience fat shifting, increased hairiness and other changes specific to the target biological sex.
3. The MTF male to female gender reassignment surgery
   • In this stage, a surgeon will remove the penis and the testicles, using the remaining tissues to shape a vulva.
   • They will then take a skin graft to make a vaginal canal, and use the gland of the penis to reconstruct the clitoris.

Gender Reassignment & SRS Change FAQs

Can gender be changed?

• Yes, you can change gender.
• The possibilities are applicable equally for both biological sexes:
  • Male to female
  • Female to male.

How can I change my gender in real life?

• You can change your biological sex to the one you desire using gender reassignment or gender confirmation surgery.
• You may switch your biological sex from male to female or from female to male.

Can a female have surgery to become a male?

• Yes, a female can have surgery to become a male.
• This is done using a gender adjustment or gender confirmation surgery and is a complex surgical procedure, including;
  • Removing breasts
  • Removing the vagina, womb and ovaries
  • And constructing a penis.

At what age can you change your gender?

You have to be at least 18 years old to change your gender in most countries.

What is it called when you switch genders?

You can switch genders through the surgical procedure known as gender adjustment, gender reassignment, or gender confirmation surgery.

What is male to female surgery called?

• Other names for male to female surgery include;
  • MTF surgery
  • Male to female surgery
  • Or MTF gender confirmation surgery.
• There are two surgeries on this path: the top surgery and the bottom surgery, depending on the area of the body operated on.
• The top surgery means breast construction
• While the bottom surgery may be called;
  • Orchiectomy
  • Vulvaplasty
  • Or, vaginoplasty, depending on what is done during the procedure.

What is female to male surgery called?

• Different names for Female to male surgery include
  • FTM surgery
  • Gender confirmation
  • Gender adjustment
  • Or, gender reassignment surgery
• It involves removing the breast tissue and the entire reproductive system, except the clitoris which the surgeon will use to reconstruct the penis gland.
• Your surgeon may also take a skin graft to rebuild the skin of the penis shaft.

How long does it take to transform from male to female?

• The entire procedure, with all three phases (psychological evaluation, hormone therapy and the MTF surgery procedure), may take years to complete.

How is gender change surgery done?

Depending on the biological sex and target sex, the surgery involves removing primary sexual characteristics and reconstructing the target sex primary sexual characteristics.

How do they do gender reassignment surgery male to female?

• Male to female MTF gender confirmation surgery procedure is a complex surgery.
• It involves removing the entire reproductive system except the prostate and the gland of the penis. This is used to reconstruct the clitoris of the new vagina.
• Your surgeon will construct breasts as well as a vaginal canal.

How do they do gender reassignment surgery female to male?

• Female to male FTM gender reassignment surgery is a complex surgical procedure.
• In women, the breasts and the reproductive system is removed while the clitoris is kept; then, a neopenis is constructed.

What happens if a man takes female hormones?

• If a man starts taking female hormones, the body will redistribute any fat deposits to more feminine-specific places, such as; the hips, breasts and the bottom.
• During estrogen therapy, men will also experience strength and muscle volume loss.

Which gender reassignment surgery is easier?

Male to female MTF gender reassignment surgery is easier and has a higher rate of success.

How common is gender reassignment surgery?

• There are between 100 to 500 gender reassignment surgeries done in the USA alone every year.
• The worldwide number may be at least two times that number and is increasing.

How much is gender reassignment surgery?

• You may expect to cash out more than AUD 30,000 depending on;
  • The extent of surgery
  • The length of hospital stay
  • Any complications
  • The kind of surgery you need
  • And, any additional medical services you may require before, during or after the surgery.

Is gender reassignment surgery safe?

• Gender reassignment surgery is generally considered safe if done by a specialised plastic surgeon with ample experience and good credentials.
• Any surgical procedure carries risks of its own, so it is best to consult your specialised plastic surgeon
• You can organise a consult with Dr Patrick Briggs, for more details and a full evaluation of your case.

Is male to female surgery painful?

• It is common to experience pain and discomfort after a male to female surgery.
• Patients can manage their pain by using pain killers that the specialist plastic surgeon will prescribe.

What is the recovery time for gender reassignment surgery?

• On average, it can take anywhere between 6-8 weeks to recover from a gender reassignment surgery.
• However, everybody recovers at a different pace.
• Some factors, such as smoking and other lifestyle choices, may prolong the recovery period.

Can FTM get an erection after surgery?

• Yes, FTM transman can get an erection after surgery, partly due to the tissues expanding due to the increased blood flow, partly due to the implant inserted into the body to mimic the shaft of the penis.

Taking Hormones FAQs – Pre-Surgery FAQs

At what age can you start taking testosterone?

• Testosterone is generally prescribed to adults only, although you may start even before the age of 18.
• Most doctors agree that testosterone should not be taken before the age of 16.

Can you take testosterone at 13?

• 13 is considered too young to be taking testosterone by most doctors.
• Most doctors recommend taking testosterone at the age of 18, although some say that 16 is a good age to start hormone therapy.
• Consult your General Practitioner or you specialised plastic surgeon to find out more details.

Can you start testosterone at 14?

• Most doctors agree that 14 is too young for testosterone hormone therapy.
• In some countries, you can start taking hormones as early as 16, although many doctors recommend 18 as a better age for testosterone therapy for young people.

What happens when you start taking testosterone FTM?

• After you start taking testosterone as a part of an FTM procedure, your body will redistribute your weight, and you may notice an increase in strength.
• An increase in body mass and especially muscle mass can be seen with hormonal therapy as well.

What do testosterone pills do to a teenager?

• A female teenager taking testosterone pills may notice a slight change in breast size, weight and fat redistribution, and muscle mass increase.
• This will increase your overall strength and any exercise you do will tone your muscles more easily.
• During testosterone therapy, you may also experience an increase in the amount of body hair you have.

Can testosterone increase size?

• Testosterone can increase the size and volume of muscle mass in your body.
• Testosterone will not increase your height or the length of your legs and feet if the growing phase is over.
• If you are still growing, however, you may expect some minor increase in the growing rate.

Does testosterone make you taller?

• Testosterone does not make you taller past the growing stage.
• It can however, increase muscle mass and strength.
• Although, you should not expect significant gains, especially not without regular exercise and a healthy lifestyle.

Does testosterone affect puberty?

• Yes, testosterone affects puberty.
• Testosterone leads to the development of secondary sexual characteristics specific for men:
  • Body hair patterns
  • Moustache and beard growth
  • A deeper voice
  • And a thinner subcutaneous layer of fat.

Does masturbating reduce testosterone?

• No studies have shown that masturbation reduces testosterone levels.
• A study has found that not masturbating can increase testosterone levels on the seventh day post masturbation.
• After the eight day, the testosterone levels were back to normal irrelevant to whether the subjects masturbated or not.

Adam’s Apple Reduction FAQs

Can Adam’s apple be reduced?

• Yes, you can have an Adam’s apple reduced, the name of this procedure is a tracheal shave.
• It is a surgical procedure that offers satisfactory results removing the protruding part of the throat without impacting voice quality.

Why is my Adam’s apple getting smaller?

• Adam’s apple does not reduce in size during lifetime.
• As you grow and develop more muscle mass and a thicker neck, your Adam’s apple may become less prominent.

Does a deep voice mean high testosterone?

• Yes, higher testosterone means a deeper voice.
• This is the case only during the growing stages in life.
• As the vocal cords are exposed to the hormone, they grow thicker and longer and vibrate on lower frequencies, resulting in a deeper voice.

Does testosterone make your Adam’s apple bigger?

• Testosterone in men does make Adam’s apple bigger. It is a normal occurrence that happens during the growing stage in life.
• In transgender men, testosterone therapy can make the vocal cords thicker and the voice deeper, but the influence on Adam’s apple size is highly individual.
• Some transgender men may experience growth while others do not.
• In general, even after long-term testosterone therapy, Adam’s apple in transgender men is somewhat smaller than in cisgender men.

What does a large Adam’s apple indicate?

• A large Adam’s apple is a sign of a larger voice box.
• It may also result in a deeper voice.

Does shaving Adam’s apple change voice?

• Shaving Adam’s apple does not interfere with vocal cords and therefore does not change the voice.

Medicare FAQs – Questions About Gender Reassignment Surgery FAQs

Is gender reassignment surgery medically necessary?

• In some cases, yes.
• For example if you suffer from gender dysphoria, gender reassignment may be a medically necessary procedure.

What is the average cost of gender reassignment surgery?

• Gender reassignment surgery costs upwards of AUD 30, 000.
• The cost depends on your exact needs and the nature of the surgery.
• Consult your specialised plastic surgeon for a more approximate cost and understand that Medicare will cover a part of your expenses if you have a referral.

Does Medicare pay for gender reassignment surgery?

• Yes, Medicare covers a part of gender reassignment surgery costs for as long as it is deemed a medical necessity.
• Your doctor should give you a referral if they think your necessity is a medical necessity and not elective surgery.