A Historical Review of Gender-Affirming Medicine: Focus on Genital Reconstruction Surgery

J Sex Med. 2017 Aug;14(8):991-1002. doi: 10.1016/j.jsxm.2017.06.007.

Abstract

Gender dysphoria (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) is characterized by a marked discrepancy between one's birth-assigned sex and one's gender identity and is sometimes addressed by gender-affirming surgery. As public visibility and institutional support for the transgender and gender non-conforming population continue to increase, the demand for competent multidisciplinary teams of medical professionals equipped to care for this population is expected to rise-including plastic surgeons, urologists, gynecologists, endocrinologists, and breast surgeons, among others. Genital reconstruction procedures for the male-to-female and female-to-male transgender patient present unique surgical challenges that continue to evolve from their respective origins in the 19th and 20th centuries. A historical review of surgical techniques and standards of care attendant to gender-affirming medicine is presented, with foremost emphasis placed on how techniques for genital reconstruction in particular continue to evolve and advance. In addition, the current status of transition-related health care in the United States, including research gaps and contemporary clinical challenges, is reviewed. Frey JD, Poudrier G, Thomson JE, Hazen A. A Historical Review of Gender-Affirming Medicine: Focus on Genital Reconstruction Surgery. J Sex Med 2017;14:991-1002.

Keywords: Gender-Affirming Genital Reconstruction Surgery; Gender-Affirming Surgery; Historical Overview; Surgical History; Transgender Health Care.

Publication types

  • Historical Article
  • Review

MeSH terms

  • Female
  • Gender Dysphoria / history
  • Gender Dysphoria / surgery*
  • Genitalia / surgery
  • History, 19th Century
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Male
  • Sex Reassignment Surgery / history*
  • Transsexualism / surgery
  • Urogenital Surgical Procedures / history*