MTF Transgender Surgery in Thailand: The Process
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Thailand is the most popular overseas destination for transgender surgery (aka “sex change”) for patients from around the world. Hundreds of transgender surgeries are performed by highly skilled surgeons in the country every year. Even with the cost of international flights and accommodation factored in, having surgery in Thailand offers significant cost savings compared to countries such as The USA, Australia or European countries.
With that said, the idea of going abroad for surgery can be daunting. You’ll need to be well prepared to make sure your operation is a success without any unnecessary complications. It’s important to do your research and know what to expect from the process, from the moment you arrive in Thailand until you’re ready to go back home.
Here is a step by step outline of what you can expect from your MTF transgender surgery in Thailand.
Obtain a Medical Certificate
First thing you’ll need to do is to arrange the date for your surgery with the clinic. After this, you can go ahead and book your flights to Thailand. You should aim to arrive at least five days before your operation.
In order to meet the requirements for transgender surgery in Thailand, you’ll need to obtain two referral letters from a certified psychiatrist. One should be from your home country and another one in Thailand. So after you land in Thailand, your first port of call will be a visit to a psychiatrist for an interview and to obtain a referral letter. This interview will most likely be very similar to the one you had before, so you should already be familiar with the questions.
Appointment with Your Surgeon
After you’ve obtained the psychiatrist’s referral, you’ll need to visit our clinic to see Dr. Theerapong, Interplast Clinic’s chief plastic surgeon. Consultations usually take place 1-2 days before surgery.
Dr. Theerapong will perform a physical examination and take your medical history. He will explain the surgical technique and discuss your wishes regarding the procedure, such as the preferred depth of your neovagina.
Hospital Admission
As the date for your operation gets nearer, you will be instructed to follow a very specific diet consisting of light meals that are easy to digest, such as congee (rice porridge) or clear soup. Dr. Theerapong will provide you with a list of foods that you’re allowed to eat. After checking into the hospital, you’ll only be able to eat clear soup before your surgery.
Patients who have chosen sigmoid colon vaginoplasty or peritoneal pull-through vaginoplasty (PPV) will be admitted to hospital one day before surgery. This is to clean the colon in preparation for the surgery. Your first day in hospital will consist of colon hydrotherapy: you will be asked to drink 2 litres of water and take a laxative in order to cleanse the large intestine.
Patients having transgender surgery via scrotal skin grafting can check into hospital on the day of the surgery.
Postoperative Recovery in Hospital
You’ll spend the first 5-6 days after your operation recovering at the hospital. At first you won’t be able to eat any solid food or drink anything. Instead, you’ll be given intravenous fluids to meet your nutritional intake. A urinary catheter will be in place the whole time to allow you to pass urine.
Sigmoid colon surgery patients will be encouraged to get up and start walking soon after surgery in order to stimulate the colon. Solid food can usually be introduced after 3-4 days. Patients recovering from PPV surgery will need to avoid walking and sitting up for the first 5-6 days. You’ll also be restricted from eating solid foods at this time.
Patients recovering from scrotal skin grafting can usually start walking and eating solid food after the first couple of days.
It’s important to note that many patients find the recovery period at the hospital the hardest part of the whole journey. You will be given medication for any post-operative pain, and nurses are there to help you with any physical discomfort, but it’s also quite important to have a family member, friend or partner with you to help you cope psychologically, if possible.
Discharge from Hospital
After 5-6 days at the hospital, the surgeon will examine you and remove your stitches. You can then be discharged from the hospital.
The urinary catheter put in place after the operation will be removed after your bladder has healed and you’re able to urinate by yourself. In case you’re not able to urinate, you’ll need to take the catheter and urine bag with you to your hotel.
It’s not uncommon for the urinary tract to be infected after surgery. If this is the case, urinating will become painful and you won’t be able to empty your bladder completely. This can be very uncomfortable as it means having to go to the bathroom very often at first (every couple of hours). However, the antibiotics you’ll be given after surgery will help clear the infection within three days.
Dilation
After surgery, you’ll need to start using a vaginal dilator to stretch the vagina and keep it open. The clinic will give you instructions on how to do this. Patients recovering from PPV surgery will need to begin dilation on the day they’re discharged from hospital. If you’ve had sigmoid colon vaginoplasty, you’ll be instructed to begin dilation and douching 7 days after the operation.
Dilation needs to be performed twice a day, 30 minutes at a time. This is an important part of your recovery and typically remains a lifelong requirement.
Recovery at Your Accommodation
Ideally, you should stay in Thailand for at least three weeks after leaving the hospital. This means you should prepare to stay in Thailand at least one month after surgery. The doctor will visit you at your hotel or place of residence once a week to examine you and discuss how you’re getting on with walking, eating, douching, dilation and so on.
If you’re arriving for your surgery alone, Interplast Clinic can arrange a patient concierge package for your improved comfort. Your dedicated concierge is a single point of contact who will help you with all practical arrangements, such as transportation and all necessary appointments. The concierge will also visit you twice a day at your hotel to assist with dilation as well as any practical tasks you may need help with.
Moving On
The recovery time varies from person to person, so it’s important to always follow the advice from your surgeon and show up for any follow-up appointments as required.
It is normal to have swelling and soreness in the labia at first. The swelling will gradually improve within 6-8 weeks, but it may take up to six months until it’s completely gone.
You will need to rest and avoid any strenuous physical activity in the first 5-6 weeks post-operation. Most patients should be able to go back to work and their normal activities after this time. Hormone treatments can typically be resumed after 3-4 weeks or when the wound is completely healed.