The discourse surrounding gender has evolved significantly in Malaysia, fostering a greater understanding of diverse identities. At the heart of this understanding lies the concept of being transgender. This guide aims to provide clarity on transgender identity, differentiate it from sexual orientation, emphasise the importance of affirmative care, discuss who might consider gender affirming surgery, outline the surgical procedures involved, and guide you on seeking support.
What is Transgender?
Being transgender means that an individual’s internal sense of self – their gender identity – differs from the sex they were assigned at birth based on their physical characteristics. Gender identity is a deeply personal and inherent sense of being a man, a woman, both, neither, or somewhere else along the gender spectrum. It’s crucial to recognise that transgender identity is not a choice but a fundamental aspect of a person’s being.
Gender Identity vs. Sexual Orientation
It is essential to distinguish between gender identity and sexual orientation:
- Gender Identity: This refers to who you are internally – your deeply felt sense of being male, female, both, neither, or fluid.
- Sexual Orientation: This refers to who you are attracted to romantically, emotionally, and/or sexually (e.g., heterosexual, homosexual, bisexual, pansexual, asexual).
A transgender woman is someone who identifies as a woman but was assigned male at birth. Her sexual orientation could be towards men, women, both, or any other gender. Similarly, a transgender man identifies as a man but was assigned female at birth, and his sexual orientation is independent of his gender identity.
The Importance of Affirmative Care for Transgender Individuals
Affirmative care is a healthcare approach that respects, supports, and validates an individual’s transgender identity. Access to this type of care is vital for the well-being of transgender individuals.
- Mental Health: Gender dysphoria, the distress caused by the incongruence between one’s gender identity and assigned sex, can be significantly reduced through affirmative care, including psychological support and medical transition.
- Physical Health: Affirmative medical care, such as hormone therapy and surgery, helps align a person’s physical characteristics with their gender identity in a safe and supportive environment.
- Social Integration: Affirmative care fosters a sense of belonging and validation, enabling transgender individuals to live authentically and participate fully in society.
Who is Suitable to Do Transgender Surgery?
Gender affirming surgery is a significant medical undertaking and is not suitable for everyone who identifies as transgender. Typically, individuals considering these surgeries undergo a comprehensive evaluation process that may include:
- Persistent Gender Dysphoria: A documented and persistent experience of distress due to the mismatch between assigned sex and gender identity.
- Capacity to Make Informed Decisions: The individual must be able to understand the risks, benefits, and potential outcomes of surgery.
- Psychological Stability: Mental health professionals assess the individual’s overall well-being and readiness for surgery.
- Hormone Therapy: A period of hormone therapy is often recommended or required to achieve desired physical changes and demonstrate commitment to transition.
- Realistic Expectations: Understanding the limitations and potential outcomes of surgery is crucial.
The decision to undergo transgender surgery is a collaborative one between the individual and a qualified team of medical and mental health professionals.
What Does Gender Reassignment Involve?
Gender affirming surgery in Asia encompasses a range of procedures tailored to the individual’s transition goals.
Feminizing Surgeries (Male to Female)
These procedures aim to create more feminine physical characteristics:
- Vaginoplasty: Surgical creation of a vagina and external female genitalia.
- Breast Augmentation: Enhancement of breast size and shape using implants.
- Facial Feminization Surgery (FFS): A set of procedures to soften masculine facial features.
- Orchiectomy: Removal of the testicles.
Masculinizing Surgeries (Female to Male)
These procedures aim to create more masculine physical characteristics:
- Top Surgery (Bilateral Mastectomy with Chest Contouring): Removal of breast tissue and sculpting of the chest.
- Phalloplasty: Construction of a penis using skin grafts.
- Metoidioplasty: Release and repositioning of the clitoris to create a smaller phallus.
- Hysterectomy and Oophorectomy: Removal of the uterus and ovaries.
Cost of Transgender Surgery
The cost of transgender surgery can be affected by several factors. Here are some reference costs:
| Transgender Surgery | Cost (Thai Baht) | Cost (SGD) |
| Penile Skin Inversion and/or Scrotal Skin |Sex Reassignment (Male to Female) | 350,000฿ | S$ 13,800 |
| Primary/Secondary Colon |Sex Reassignment (Male to Female) | 500,000฿ | S$ 20,000 |
Disclaimer: The prices listed are estimated and for reference purposes only. The final, exact amount for any treatment or service will depend on your individual medical needs, the complexity of your case.
Transgender surgery is a highly personalised medical service with a complex cost structure. The final expenditure will depend on your unique needs, the combination of surgeries chosen, the doctor’s professional fees, and the pricing standards of the medical institution.
Preparing for Transgender Surgery
Preparing for transgender surgery involves several important steps:
- Consultations with Specialists: Meeting with experienced plastic surgeons, urologists, and gynaecologists who specialize in gender affirming surgeries.
- Hormone Therapy: Following a prescribed hormone regimen as recommended by an endocrinologist.
- Mental Health Support: Engaging with therapists or counsellors to address any anxieties, expectations, and social aspects of transition.
- Physical Health Optimization: Maintaining a healthy lifestyle and addressing any pre-existing medical conditions.
- Understanding the Surgical Process and Recovery: Discussing the details of the chosen procedures and the expected recovery timeline with your surgical team.
Transgender Health Support in Thailand
Navigating your transgender journey requires access to knowledgeable and compassionate healthcare providers in Thailand. Whether you are seeking initial information, mental health support, hormone therapy, or exploring gender affirming surgical options, our platform can connect you with experienced medical professional in Thailand.
Schedule A Consultation With Dr Tawisak Labchitkuson
If you are looking for qualified medical professionals to discuss your transgender healthcare needs, please contact us 365Care or Whatsapp: +65-9099 1662 for a confidential consultation and guidance.
Resources:
1.American Psychological Association | Understanding transgender people, gender identity and gender expression, https://www.apa.org/topics/lgbtq/transgender-people-gender-identity-gender-expression
2. Ontario Human Rights Commision | Gender Identity and Gender Expression, https://www3.ohrc.on.ca/en/policy-preventing-discrimination-because-gender-identity-and-gender-expression/3-gender-identity
3. American Psychological Association | Understanding sexual orientation and homosexuality, https://www.apa.org/topics/lgbtq/orientation
4. Transequality | Frequently Asked Questions about Transgender People, https://transequality.org/issues/resources/frequently-asked-questions-about-transgender-people
5. U.S. Centres For Disease Control and Prevention | Sexually Transmitted Infections Treatment Guidelines, 2021, https://www.cdc.gov/std/treatment-guidelines/trans.htm
6. Brigham and Women’s hospital | Gender Affirmation Surgery, https://www.brighamandwomens.org/transgender-health/surgical-care
7.IM Gender Clinic | Everything About Transgender Surgery, https://cirugiadegenero.com/en/everything-about-transgender-surgery/#:~:text=Want%20to%20learn%20more%20about,We%20are%20here%20to%20help
8.AMA Journal of Ethnics | Ethically Navigating the Evolution of Gender Affirmation Surgery, https://journalofethics.ama-assn.org/article/ethically-navigating-evolution-gender-affirmation-surgery/2023-06
Disclaimer: 365Asia aims to provide accurate and up-to-date information, our contents do not constitute medical or any professional advice. If medical advice is required, please consult a licensed healthcare professional. Patient stories are for general reading. They are based on third-party information and have not been independently verified.