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• W2946822683 abstract "Sir: Among the most influential factors contributing to patients suffering from gender dysphoria to seek sex-confirmation surgery is their desire to attain a higher quality of life.1 Addressing this dissonance through surgical correction has the potential to grant the individual a novel beginning, with surgery representing the most invasive means (and for many patients, the final hope) for achieving their ideal quality of life.2 To this end, sex-confirmation surgery by nature constitutes a genesis of life, created from materials of a prior life. Challenging the dogma of “reconstructive” surgery, this approach to “creation” of previously nonexisting anatomical structures and physiologic responses in the patient undergoing sex-confirmation surgery goes beyond the restoration of form and function. This definition of “creation” in gender-affirming surgery applies broadly, in both female-to-male and male-to-female operations. In female-to-male phalloplasty, the construction of a neophallus from autologous tissue is directly intended to create an aesthetic, sensate, functional penis for micturition and potential penetrative sexual intercourse.3 Much the same, in male-to-female vaginoplasty, the creation of a novel vaginal canal predicates the goal for aesthetic optimization of female anatomy, and functional neural connectivity and physiologic response to stimuli.4 These goals of treatment are novel structures and functions to these individual patients. Thus, we advocate for the recognition that plastic surgeons direct the efforts of the transgender care team to create rather than reconstruct what once was. Multidisciplinary care teams in transgender health care services aim to improve long-term patient comfort and wholeness through psychological, hormonal, and surgical interventions.5 Being that a patient must be deemed psychologically prepared and equipped to pursue surgical treatment for gender dysphoria, this stepwise progression to the ultimate goal of functional and structural transition eases the patient into the commencement of their novel identity. Although patients seeking gender-affirming surgery are often candidates for a number of different procedural options and techniques, the ultimate objective remains universal: to definitively ameliorate the incongruence between their true gender and inherent anatomy by way of creating unison of body and identity. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article. Jeremie D. Oliver, B.S., B.A.Mayo Clinic School of MedicineRochester, Minn. Saad A. Alsubaie, M.B.B.S.Krishna S. Vyas, M.D., Ph.D., M.H.S.Arif Chaudhry, M.D.Division of Plastic SurgeryMayo ClinicRochester, Minn. Antonio Jorge Forte, M.D., M.S., Ph.D.Division of Plastic SurgeryMayo ClinicJacksonville, Fla. Jorys Martinez-Jorge, M.D.Oscar J. Manrique, M.D.Division of Plastic SurgeryMayo ClinicRochester, Minn." @default.
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• W2946822683 date "2019-08-01" @default.
• W2946822683 modified "2023-10-17" @default.
• W2946822683 title "“Creation” rather than “Reconstruction” in Gender-Affirming Surgery" @default.
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• W2946822683 doi "https://doi.org/10.1097/prs.0000000000005855" @default.
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