When a person feels their body is not in harmony with who they truly are, it is important their physician is the right partner in the process. After psychotherapy, hormone replacement therapy, and living as a member of the preferred gender, some trans women and men may opt for a more significant change through gender confirmation surgery.
Gender confirmation surgery or previously referred to as gender reassignment surgery can transform the life of a transsexual person. Not long ago, Medicare lifted a 33-year ban on coverage for this type of surgery.
Fortunately, many U.S. companies are now providing transgender health benefits for their employees, making life-changing transgender surgical procedures available to more trans men and women than ever nationwide. At Dr. Sinclair's Los Angeles Transgender Surgery clinic, Dr. Alexander Sinclair has focused his practice on gender confirmation and transgender surgery.
Dr. Sinclair is a general plastic surgeon with a compassionate approach and several decades of experience in all types of complex plastic surgery. The doctor and his staff are committed to surgical excellence and a comfortable treatment experience for their transgender patients.
The World Professional Association for Transgender Health (WPATH) has adopted certain standards of care for GCS in Los Angeles. Seeing a mental health professional for diagnosis and psychotherapy is the first step under those standards.
A patient with a gender identity disorder or gender dysphoria diagnosis and a letter of recommendation from a mental health therapist may see a doctor to begin hormone replacement therapy. A period of living publicly as a trans man or woman is required before gender confirmation surgery is performed.
In transgender hormone replacement therapy, androgens (male sex hormones, primarily testosterone) are given to trans men to promote the development of male sex characteristics, such as body and facial hair and upper-body muscle mass.
Estrogen and anti-androgens (drugs that block the action of male sex hormones) are administered to trans women to produce changes in body hair, skin, fat distribution, and musculature to make them appear more feminine.
After hormone therapy is begun, Dr. Sinclair and other plastic surgeons who follow WPATH guidelines may require candidates for gender confirmation surgery to live for up to a year in the preferred gender role before the surgery is performed.
In fulfilling our Los Angeles GCS prerequisites, Dr. Sinclair will require two letters of recommendation from two separate mental health professionals, and proof of two years of hormone treatment. Dr. Sinclair requires a patient to have a healthy weight or BMI prior to surgery. During consultation, he will evaluate and advise you on what your BMI will need to be before your surgery date.
Dr. Sinclair strongly recommends MTF gender confirmation surgery patients receive genital electrolysis prior to undergoing surgery. While it may at first appear this is solely cosmetic, it is more significant than that. In performing GCS, Dr. Sinclair moves many tissues around, and some that were on the surface will be inside the vagina after surgery. By permanently removing the hair from the genitals, we ensure you don’t experience hair growth within your vagina, which can be both uncomfortable and embarrassing.
Dr. Sinclair follows the World Professional Association of Transgender Health (WPATH) guidelines. You will need two letters of recommendation from mental health professionals. You will arrive in Los Angeles 48 hours before the surgery and undergo a bowel prep the day before the surgery. The surgery is done in a hospital under general anesthesia with a 3 night stay.
You will stay in Los Angeles for a week after your hospital stay. The office will assist you in making arrangements. Prior to leaving Los Angeles, Dr. Sinclair and his staff will teach you how to use your dilator. Patients can return to work two to three weeks after surgery and can begin sexual intercourse three months after surgery.
Female-to-male (FTM) genital reassignment surgery is more expensive and less commonly performed with a lower success rate than male-to-female GCS. The breasts and the uterus and ovaries are removed in two separate surgical procedures. A neo-phallus may be constructed using tissue from the forearm, thigh, or stomach, or the clitoris, which has been enlarged with male hormone therapy. The urethra may be extended to allow for standing urination, which is the most difficult part of the procedure.
This surgery is less successful than MTF genital reassignment for two basic reasons:
Many trans men do not opt for genital reassignment surgery. Most choose instead to undergo hormone replacement therapy, top surgery (bilateral mastectomy and chest contouring for a more masculine appearance) and hysterectomy (removal of the uterus and ovaries).
Hormone replacement therapy alone can produce masculine sexual characteristics, such as:
Dr. Alexander Sinclair is a preeminent transgender plastic surgeon, serving patients from all over the country and throughout the greater Los Angeles area, with offices located in Beverly Hills. After several decades of practice performing complex surgical procedures, he has the experience that makes it far less possible for his patients to have complications.
He has focused his Beverly Hills practice on serving the transgender community, performing a range of transgender procedures, including gender confirmation surgery, with a commitment to surgical excellence.
In addition to providing the highest quality medical care, Dr. Sinclair and staff make it a priority to create a warm and comfortable environment, and a pleasant treatment experience. Dr. Sinclair is well known for his compassionate bedside manner and his willingness to listen attentively to his patients, answer their questions, and address their concerns.
If you are ready for gender confirmation surgery -- the final step in transitioning to another gender -- we invite you to contact us at our Beverly Hills office for a free consultation to discuss how best to suit this procedure to your physique.
The decision about which surgery to employ in your case will be based upon several factors, including the final appearance and functionality you want to achieve. Colon graft surgery has the advantage of creating a deeper vaginal canal, which can be an important issue for the individual patient. At Dr. Sinclair's Los Angeles Transgender Surgery clinic, Dr. Sinclair works closely with each patient to determine the most effective procedure to suit the individual patient.
Dr. Sinclair is a member of, and adheres to the World Professional Association of Transgender Health guidelines. You will need two letters from competent mental health caregivers recommending GCS. You will need medical clearance from your family doctor before coming to Los Angeles.
Dr. Sinclair uses a penile inversion technique. The vagina will be a sensate flap from the penile shaft; length will be augmented with a graft from the scrotal skin. A portion of the urethra will be used as mucosal lining from the vagina to the clitoris. The clitoris is created from the dorsal glans penis and will have sensation from the dorsal sensory nerve. Every effort will be made to give the clitoris orgasmic potential. Surgical time is about 3.5 hours. Anesthesia is done with an endotracheal technique. The usual hospital stay is 3 nights. Packing and urine catheter are left in place for several days. Dilation begins after packing is removed.
A 10-day stay is recommended.
Most patients return to work in 3 weeks.
Most patients can begin vaginal intercourse 3 months after surgery.
Yes, Anita will work with you to get coverage.
Updated - June 26th 2020
The COVID-19 epidemic has created unprecedented circumstances for our community. Our practice has been paying close attention to the guidelines put in place by the government and
With this in mind, we are offering virtual consultations to patients via face time, however, face-to-face in-office consultation are still available. We are still seeing post-operative patients and patients requiring ongoing treatments. To schedule, a virtual consultation or in-office consultation call our office.
Please know that we are constantly updating our services and staffing according to the local and national recommendations and doing our part to make sure that you are protected
However, we have now increased this routine and are wiping down all surfaces, desks, door handles, keyboards and restroom facilities multiple times each day.
Although Covid-19 is a serious issue, we strongly believe that it will pass and hopefully make our infrastructure and our ability to deal with pandemics in this country even better than it currently is. We are closely monitoring this situation on a real-time basis and will update our practice’s guidelines as needed to protect our patients.
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