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This is the last surgical step for unusual sex realization. This procedure is for creating female reproductive organs from male reproductive organs <or male reproductive organs to female reproductive organs> to conform external look with sense of being.
Generally, sex reassignment surgery must consider quality and mental status which is ready for operation. Patient must pass the inspection from psychologist which have completely world quality as following ;
1. Have been living as female routine more than one year.
2. Used to live as female completely and accepted by people surrounded together without any pressure.
3. Have feeling as female for a long time or since born.
4. Have disgusting feeling on your own genital and think that t is the surplus organ in body.
5. Dislike homosexuality behavior
6. Used to take female hormone before whether eating drug or injection. It’s because if female being is not the real attention, there is no man taking female hormone absolutely.
7. Have been evaluated mental status by psychologist which considers as in normal status and ready for taking operation together with certificate guarantee the mental status test for operative.
1. The anesthesiologist will administer an anesthetic to the patient so the patients will not have any pain during procedure.
2. The procedure of male to female sex reassignment surgery is begin with vaginal cavity creation by using tissue in front of rectum and move it to above rectum where is under urethra level. Later, operate the skin opening as enough widely and deeply channel. The wide about 1.5-2 inches is could use as the artificial vagina created which seems real vagina cavity of female.
3. After that, the surgeon will removes the skin around the male ex-genital of patient to dam as the vaginal cavity. This planted partition is come from scrotum skin. Depth of vaginal cavity is depending on how long does the male reproductive organ.
   

4. Another technique for vaginal cavity creation is cut and connect male urethra. Surgeon will decorate it in shape which could open or close in right position for urination. If it’s not in the right position when go for urination the urine may hurl up in the air. After that surgeon will pen channel around that area for create artificial vaginal cavity.
5. External vaginal cavity decoration such as labia minora and labia majora surgeon will use special technique to imitate labia as similar as female reproductive organ. In this technique, surgeon will use skin around the scrotum by cutting one side of testicle out.
Later, take the skin and tissue around this area to decorate and create the shape of external organ as seem as female reproductive organ as impossible as it could.
6. Last process, is to decorate sensory nerve for being the sexual sensory lump of female which is called Clitoris. Generally, it was found that sexual sense is still the same and more confidence will being.
Post operation, patient should recuperate in hospital about 5-7 days as doctor prescribe. Patients will be under supervision of doctor closely and during these time doctor will give the suggestion as follow;

1. Reduce fibers food and milky beverage which cause the fiber source and conduct the excrete among first 2 days that cause infection.
2. At bedtime, should sleep in the pose of legs separated. Patient may use the blanket lie between legs while sleeping to prevent pressing on the wound.
3. Should clean vaginal by chemical solution for protection and kill germ or sterile to clean the wound for protect the infection.
4. Should start walking 5 days after operation period.
5. Take care of vanigal cavity for not narrowed and hollow by using a small size dilator which is made from soft silicon or liquid candle. It has an appearance same as male reproductive organ. This is use for stable wide and increase deep of the channel. Patient should always expand the artificial vaginal cavity at least 2 times about 30 minutes each.
6. Stop having sex at least 2 months after operation.
7. Start taking hormone 1 week after operation.
8. See doctor as prescribe 1 week after operation. Stitches out and re-examine for the better treatment.

Sex reassignment surgery is not only the major operation. It’s also influence on live that is changes after the operation. Preparation in education, surgery information, specialist choose and ask yourself seriously is necessary for successful operation and satisfy for everyone.

The result that patient could receive from sex reassignment are mental happiness from appearance change, could determinate genital that is the surplus organ and disgusting out of the body. New female genital created, it has the shape closely to the natural appearance, there is also the Clitoris which is good in having sex sensual.

Operation in sex reassignment is advance in present time. Besides it should help patients to have the body status conform with the mental status. It’s also giving the treatment result the closer to the natural. The majority is that patient must have good discretion. Also patient should pass the mental status test from the psychologist that there is any suitable and choose to take the operation in the standard hospital where have the specialist surgeon which could make patient back to live in social happiness and usefulness for the country later on.

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