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For anyone looking for guidance about their gender experience and decision making process I recommend BetterHelp. Here's their site: to try online counseling today.

This episode has been in the making for years. I knew that I wanted to talk about the surgical ways that people transform their body's related to gender and sexuality but how and when I did it took some time to determine.

This year Blake, a long time sexpla(i)naut and research assistant for the channel visited me in Missoula and we figured out a way to communicate this topic in a way that I think is very cool -- terminology, experience, and resources for support.

Here is a list of the terms for reference:
Pre-op/pre-operation: before desired gender affirmation surgery
Post-op/post-operation: after desired gender affirmation surgery
No-op/no-operation: decided not to have gender affirmation surgery
Top surgery: operations on the chest to affirm gender
Mammoplasties/breast augmentation: surgical modification of the chest
Bottom surgery: operations on the genitals or reproductive organs
Hysterectomy: removal of a uterus and often the cervix
Oophorectomy: removal of one or more ovaries, often including the fallopian tubes
Orchiectomy: removal of one or more testicles
Penectomy: removal of a penis
Vaginectomy: surgical removal of a vaginal canal and the closing of the vaginal opening
Vaginoplasty: surgical creation of a vulva
Chondrolaryngoplasty/tracheal shave: type of facial feminization surgery in which the thyroid cartilage that protrudes in the neck (an Adam’s Apple) is shaved down with a scalpel to give it flatter appearance
Feminization laryngoplasty: changing the voice box and vocal cords of the larynx to raise the pitch of one’s voice

I hope you learn something useful and stay curious. If you have any questions or comments about the episode I usually read and respond in the comments section for an hour after uploading a video.

Dr. Doe's contact info:
Support Sexplanations by becoming a sexpla(i)naut:
My name is Lindsey Doe and this sex curious show is Sexplanations.

Today's episode is sponsored by BetterHelp, a mental health resource you can access from lots of different devices to understand and explore your gender, body, and/or sexuality. [WHIP CRACKING, COUGH]. Transgender and non-binary people are often asked, “Have you had the surgery?” This question stems from a common misconception - that there is one surgery to affirm one's gender, and that all trans people want it.

First of all, there are many different types of “gender affirming surgeries” - once called sex reassignment surgeries, and second, not all trans people desire altering their bodies. This video is meant to serve as a list of current gender affirming surgery options, for anyone who may want them, anyone who may want or need to learn about them in order provide care for others, and anyone who's curious.

Note: We're primarily using medical terms for surgeries and body parts, but there are other ways to describe these procedures and their organs. Let's start with the term pre-op... as in pre-operation. It's used to refer to someone who wants a gender affirming surgery but hasn't had it. Post-op refers to someone who has had a specific surgery and no-op is used for folks who don't want surgery.

A person may describe themselves as pre-op, post-op, or no-op, or may be more specific... like my friend Blake. [

Blake:] I would describe myself as post-op top, and no-op bottom. Top surgery is shorthand for any surgery that makes someone's chest larger or smaller for reasons tied to their gender. This could include mammoplasties or Breast Augmentation in which breast tissue is transplanted or implanted, but it's more commonly among trans and non-binary people who were assigned female at birth to distinguish their chest procedure from... Mastectomies which are generally more invasive, reserved more for cancer patients and don't result in a chest reconstructed with pecs and nipples.

Bottom Surgery refers to surgeries that alter genitals or reproductive organs, including (on screen: hysterectomy, metoidioplasty, oophorectomy, orchiectomy, penectomy, phalloplasty, vaginectomy, and vaginoplasty). Surgeries that end with the suffix -ectomy involve removing organs:. Hysterectomy refers to the removal of a uterus and often the cervix.

Oophorectomy is the removal of one or more ovaries, often including the Fallopian tubes. Orchiectomy is the removal of one or more testicles. Penectomy is the removal of a penis.

Vaginectomy is the surgical removal of a vaginal canal and the closing of the vaginal opening. Bottom surgeries that end with the suffix -plasty are intended to alter or form genitals. Vaginoplasty is surgical creation of a vulva.

Usually this includes creating a clitoris, labia, vagina, and urethra, but there's only one set of lips and the vagina is pretty shallow. Sometimes an additional procedure is done to lengthen the vaginal canal and add a labia minora (labiaplasty). [Lindsey:] Blake, take over! [

Blake:] For people assigned female at birth, like me, there are two categories of bottom surgery. Metoidioplasty, meta for short, is a genital surgery to lower and lengthen erectile tissue into more of a neopenis. In anatomical terms, separating the clitoris from the labia minora and suspensory ligament that attaches it to the pubic bone, to make it a penis. Sometimes relocating the urethra, so the person can urinate from the tip and so that the genitals look like a small penis, or micropenis.

Phalloplasty is the creation of a phallus, or penis, by surrounding a pump or rod system with a skin graft from another part of the body. The internet has tons of images of transmen with forearm scars showing the surface area used for their phalloplasties. Scrotoplasty is the formation of a scrotum (usually from the labia majora).

It's a clever location for the pump bulb of a phalloplasty to be placed, because you can squeeze one ball to get an erection, and then squeeze the other to deflate it. [Lindsey:] Some other surgeries that aren't considered top or bottom surgery include:. Buttock Augmentation: is just that, a surgery to make or enlarge the size or shape of the buttocks. Facial Feminization Surgery (FFS): a set of procedures that alter typically masculine facial features so they're closer to what one's society sees as feminine or female facial features.

This might entail a brow lift, rhinoplasty (or nose job), cheek implants, and/or lip augmentation. Chondrolaryngoplasty more commonly called a tracheal shave is a specific type of facial feminization surgery in which the thyroid cartilage that protrudes in the neck (an Adam's. Apple) is shaved down with a scalpel to give it flatter appearance.

Feminization laryngoplasty is a complicated process of changing the voice box and vocal cords of the larynx to raise the pitch of one's voice. Many of the other changes to one's voice and body may involve hormones, therapy, and socialization. [

Blake:] I was assigned female at birth, meaning that when I was born, doctors said, “it's a girl.” I identify as FTM though, a female-to-male trans person. My pronouns are he/him/his. I express my gender in a lot of ways. Clothes, glasses, hair.

I have facial hair from testosterone injections that I choose not to shave because it makes me feel better. In 2015 I had top surgery, and then this year I had a hysterectomy and bilateral oophorectomy. Ovaries, Fallopian tubes, and uterus gone.

See these tiny little scars? There's also one in my belly button. None of these are because I think they make me more of a man.

They just feel correct for me. Before my hysterectomy, my doctor asked if I wanted to do a vaginectomy at the same time. He said if I wanted a metoidioplasty or a phalloplasty in the future, it would be easier to do the vaginectomy now.

I opted out. I didn't want my breasts or my uterus, but for now I'm comfortable with my vagina and vulva. This doesn't make me any less trans. [Lindsey:] It's important to remember that not all transgender or non-binary people want or get these gender affirming surgeries, and not all people who undergo these procedures identify as transgender or non-binary.

Some cisgender people, who identify with a gender attached to their sex assigned at birth, may experience them for a variety of reasons. Your identity is valid, regardless of the surgery you want or don't want, have or don't have. There is no one correct way to be trans or or cis or questioning.

There's no one way to be okay in your body. Stay curious. If you're not feeling okay in your body and/or you've got other challenges that feel unmanageable, I highly recommend's online counseling service.

You can use their services by going to which supports Sexplanations. When you visit their website, there's a short questionnaire, male, female, non-binary. Not comprehensive but progressive.

If having a counselor who specializes in LGBT identities is important to you, you can let. BetterHelp know. You can mark it as as a top priority.

Once they receive your answers, give them a few days and you'll be matched with a licensed counselor or therapist who can show you support and empower next steps. Start getting help today through