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Gender Affirmation Surgery

Gender Affirmation Surgery, also known as Gender Confirmation surgery or Transgender Surgery (previously known as Gender Reassignment Surgery) is now offered in Victoria by Coco Ruby Specialist Plastic Surgeons.

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 distress and anxiety, Gender Dysphoria is not a mental illness.

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

In 2007 the 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 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

Feminisation Surgeries

Masculinisation Surgeries

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 change the shape for a more feminine appearance. Transgender Breast Augmentation, Feminising 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 reshaping 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.

A WPATH (World Professional Association for Transgender Health) letter is a recommendation letter, typically from a mental health professional that is needed for many gender-affirming surgeries. The letter must determine that a person is ready for the surgery and affirms the individual’s gender identity, it must also explain why this surgery is medically necessary. In order to obtain a WPATH letter, a patient will need to meet certain criteria and undergo an evaluation with a mental health professional.

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 feminine characteristics and induce masculine features, often used when an individual is transitioning from FTM or FTN.

2. Estrogen therapy.

Estrogen helps to induce feminine 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 through medicare.

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 always necessity. Doctors will often test patients’ hormone levels before surgery to ensure they are within the targeted range.

Frequently Asked Questions About Gender Affirmation Surgery

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 Male to Female (MTF) and Female to Male (FTM) surgery results in some degree of scarring. But scars can gradually fade and flatten over time.

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

  • Your surgeon can give you suitable 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?

  • It depends on the procedure and the surgeon.

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

How do you know if you are nonbinary?

  • If you feel that the expressions such as male/female, man/woman, and 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.

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.

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 $30,000.
  • The cost depends on your exact needs and the nature of the surgery.
  • Consult your Specialist Plastic Surgeon for a more approximate cost and understand that Medicare will cover a part of your expenses if you have a referral.

Why Choose Coco Ruby Plastic Surgery?

Choosing a Specialist Plastic Surgeon means you are choosing an accredited recognised plastic surgeon that performs surgery in an accredited hospital. Look for members of FRACS (Fellow of the Royal Australasian College of Surgeons) memberships. ASPS (Australian Society of Plastic Surgeons) ASAPS (Australian Society of Aesthetic Plastic Surgeons) or ISAPS (International Society Aesthetic Plastic Surgery) as some of the Qualifications of your Plastic Surgeon

Dr Craig Rubinstein
Dr Broughton Snell
Dr Stephen Kleid
Dr Gary Kode

Specialist Plastic Surgeon MED0001124843 Dr Craig Rubinstein

Dr Craig Rubinstein is a Specialist Plastic Surgeon based in Hawthorn East, Melbourne. With over 20 years of surgical experience especially in all areas of Cosmetic and Plastic Surgery, but particularly in breast surgery. These include Breast Augmentation and Breast Reduction as well as Breast Surgery Revision.

Furthermore, he believes that surgical customisation, precision planning and technical expertise help him to provide optimal surgical outcomes for his patients.

Specialist Plastic Surgeon MED0001190266 Dr Broughton Snell

Dr Broughton Snell is a Specialist Plastic and Reconstructive Surgeon based in Melbourne, Victoria, Australia. His training in Plastic Surgery took place in Australia and the United States of America (USA).

Dr Snell is a fully qualified specialist plastic surgeon having completed his Fellowship with the Royal Australasian College of Surgeons in plastic and reconstructive surgery. He has also spent time following the completion of this qualification gaining further experience and training in the area of craniomaxillofacial surgery, training which he completed in world-renowned centres here and in the United States.

ENT (Ear, Nose and Throat) Surgeon MED0001052799 Dr Stephen Kleid

Dr Stephen Kleid is an experienced Ear, Nose and Throat (ENT) Surgeon (Otolaryngologist) based in Melbourne with a passion for Septo-rhinoplasty, Septoplasty, as well as, a strong interest in Rhinoplasty Revision.

Dr Kleid trained at Melbourne University, then completed surgical training at various hospitals including Royal Melbourne, Royal Children’s, The Eye and Ear and St Vincents. He worked as a surgeon at the University of Florida Medical school for further experience.

Specialist Plastic Surgeon MED0001405964 Dr Gary Kode

Dr Gary Kode is a Specialist Plastic Surgeon, with experience in Aesthetic and Reconstructive Surgery, as well as non-surgical treatments.

Dr Kode is a member of several organisations, including the Australian Society of Aesthetic Plastic Surgeons (ASAPS), The International Confederation for Plastic and Reconstructive and Aesthetic Surgery, and he holds a Fellowship with the Royal Australasian College of Surgeons.

What to do next?

Our Patient Liaison Team can assist with any questions you may have when considering a procedure. You can send in an enquiry form below or call our Melbourne Clinic between 9 am – 5 pm Monday - Friday.

Disclaimer: Results depend on individual patient circumstances and can vary significantly. Results may also be impacted by a variety of factors including your lifestyle, weight, nutritional intake and overall health. Consult your Specialist Plastic Surgeon for details. This information is general in nature and is not intended to be medical advice nor does it constitute a doctor-patient relationship. Surgery risks and complications will be covered in detail during a consultation with your Surgeon.

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