Woman with gender dyphoria clinically transforms into man after gender surgery at Delhi hospital

A 34-year-old woman from Uttar Pradesh with a condition called Gender Dyphoria underwent gender reassignment surgery at a private hospital in Delhi and successfully transformed into a man, doctors at the facility said.

The Department of Plastic and Cosmetic Surgery, at Sir Ganga Ram Hospital, received a case of the 34 years old female, Gayatri, (name changed) who wanted to get completely transformed into a man.

By all proportions and psychiatric evaluations, it was found that although the patient was female, mentally she was a male, a condition which is called Gender Dysphoria.

The woman successfully completed her gender change surgery two months back, the hospital said.

Gayatri underwent bilateral breast removal in 2017 and uterus, ovary and vaginal removal in 2019. She was on male hormone replacement therapy since 2016.

According to doctors, when Gayatri arrived at hospital, she had all male characteristics including a beard, hair on the chest, male voice and male behaviours.

"We decided to perform penile reconstruction (Phalloplasty) for complete male transformation by the state-of-the-art micro-surgical technique of tissue transfer. Our aim was to give good shape, length, urethra (to pass urine) and erotic sensation to the patient," said Dr Bheem Singh Nanda, Senior Consultant, Department of Plastic and Cosmetic Surgery, Ganga Ram Hospital.

Of all the techniques we chose the forearm as a donor for penile reconstruction. This was a challenging surgery as the penis was fabricated on the forearm with the preservation of vessels and all the important nerves. The next step was to implant the reconstructed penis from the forearm to the genital area of the patient.

"The second challenge was to join the urethra (urine tube) and then connect the vessels to establish the blood circulation again in the reconstructed penis. The last and the most important step was to join the nerves of the reconstructed penis with the erotic nerves (Pudendal nerve and nerve to clitoris) which is the most important pre-requisite for a penile implant and sexual satisfaction later," Dr Nanda said.

According to a statement by the hospital, the surgery was completed successfully and took about eight hours with minimal blood loss.

Six weeks post-surgery the patient is completely male with 5 inches of the male sexual organ (penis). Now Gayatri is Mahesh and passes urine in a standing position and uses a male urinal, the hospital said.

Mahesh is now married to Shalini, "who was the love of his life since his student days."

"Phalloplasty has matured considerably over the last decades in reconstructive options and technical refinements, thanks to increasing recognition of gender dysphoria. The primary goals of performing a phalloplasty are to facilitate sexual penetration, protective sensation, orgasm, standing micturition, and natural aesthetic, ideally in a few stages and with minimal morbidity. Radial forearm free flap and anterolateral flap are the most common options, each with a unique profile of complications, aesthetic, and functional outcomes, Dr Nanda said.

"Choices for reconstruction must be tailored to the individual patient's goals and available tissue characteristics. In Gayatri's case, we chose the radial forearm flap technique because it gives better shape, urethra quality and good sensation as compared to other techniques," Dr Nanda explained.

( With inputs from ANI )

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