Talk:Gender-affirming surgery (male-to-female)

message: Removed "Prior to any surgeries, transsexual and transgendered people must usually abide by the Standards of Care for Gender Identity Disorders set by the Harry Benjamin International Gender Dysphoria Association." and replaced again with "Prior to any surgeries, transgendered or transsexual people usually undergo hormone replacement therapy."
The formal requirements of SRS are discussed at lenght in Sex reassignement surgery and in Standards of Care for Gender Identity Disorders. This page is only about the surgery itself. This was done after reaching consent about the matter, see Talk:List of transgender-related topics. Also, the HBIGA-SoCs are not the only SoCs in the world; the Wikipedia is an international project and should not have a US-POV. 
Also removed under "see also" Transsexuality and Sex reassignment surgery. The first link is POV, since not only transsexual people have SRS, and the second unnecessary, because it is already the very first link in the article. Also, the List of transgender-related topics was done so that a single link is sufficient; both links are of course on that list, together with many other important ones. -- AlexR 10:47, 16 May 2004 (UTC)
thread_title: removed

message: The end of the first paragraph "other procedures" linked to back to this same article.  I removed the link because it was confusing.--Lavi 18:20, 28 June 2006 (UTC)
thread_title:  link to same page 

message: Is prostate removed during male to female sex change?  —Preceding unsigned comment added by 83.21.178.250 (talk) 13:21, 10 August 2008 (UTC)
thread_title:  Prostate 

message: Because of the fact check going back to August 2007 and the lack of any sources referenced, except for one broken link, I have removed most of the article, excepting the templates, links, introduction, etc.  I think it would be good if future editors first found cites for the introductory paragraph and then not add anything without reliable sources.  I will add that this article is now a stub. Cornince (talk) 11:37, 12 November 2008 (UTC)
replies: text: Thank you for that. It's Jan, 2018 now, and still, there is lack of source referrals in much of the article. I think it would be a good idea to again remove much of this article, which reads like WP:OR, and a promotional sales pitch without talking about the risks and negative long-term outcomes. I will begin on this as I have time. Juliet Sabine (talk) 22:08, 1 January 2018 (UTC)
thread_title:  Removal of Most of Article 

message: There is a move discussion in progress on Talk:Sex reassignment surgery which affects this page. Please participate on that page and not in this talk page section. Thank you.  —RMCD bot 15:14, 1 March 2016 (UTC)
thread_title: Move discussion in progress

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thread_title:  External links modified 

message: I don't want to get into an edit war here, but the idea that the body treats a neo-vagina as an open wound is plainly absurd. This is rhetoric used by anti-transgender people to both scare, and delegitimize transgender people. 
I'll say that the entire article seems to mostly be out of date with modern surgical practices.   The thailand procedures are very common and are not described here.  
The vagina will not "close up" if you do not dilate, except in the very early stages of healing (when raw sutures are exposed to each other).  Once the initial healing is complete, there is no risk of that.   The risk is some loss of depth and loss of flexibility.    None of the sources provided state anything otherwise.    
Trysha (talk) 21:39, 8 January 2018 (UTC)
replies: text: Hi, Trysha. As seen here, an IP (who seems to have been you) removed more than just the "open wound" part, and I restored the material with academic sources. We follow what WP:Reliable sources state with WP:Due weight and they are clear that dilation is needed, with one of the sources I included stating, "Dilators of increasing size are regularly inserted into the vagina at time intervals according to the surgeon's instructions. Dilation is required less often over time, but it may be recommended indefinitely." Because of what the latter sources states, I also included the following in the section: "Over time, dilation is required less often, but it may be required indefinitely in some cases." Either way, I was focused more so on the loss of all of the content. As for the "open wound" part specifically and you removing it, it is not simply "anti-transgender people" rhetoric. Although some anti-transgender people may state this, I have never known an anti-transgender person to focus on that aspect. The vast majority of laypeople know nothing about this aspect of genital surgery. They simply think that a penis is cut off, although many of them know that having an opening is part of the surgery. I am far from anti-transgender and also once stated, "Those who get the surgery to construct a vagina, meaning to create an entire vagina, need to dilate the vagina; this is because the vagina will begin to narrow and close, like a wound healing itself." Over the years, I have come across academic sources and sources by transgender people stating that the body treats the opening like a wound to be sealed. Why do you think dilation is needed during the early process and less often over time and that the opening will otherwise try to close up, resulting in vaginal stenosis? That stated, I haven't noticed the "a wound" wording as being prevalent in the medical literature. And although the "a wound" aspect can help readers understand why dilation is needed, I am not hard-pressed on the wound aspect being re-added. I replaced the mention with mention of vaginal stenosis (which was already noted in the article) instead and added a small "recommendations" piece. We can also bring WP:Med editors in on this matter. Flyer22 Reborn (talk) 00:11, 9 January 2018 (UTC)
thread_title:  "Treated as an open wound" 

message: The following Wikimedia Commons file used on this page has been nominated for speedy deletion:
* 
You can see the reason for deletion at the file description page linked above. —Community Tech bot (talk) 10:07, 15 April 2019 (UTC)
thread_title:  A Commons file used on this page has been nominated for speedy deletion 

message: I have no personal or professional stake in this subject, but as 'transgender' issues are increasingly in the news, curiosity brought me to this article.  Presumably it will be the first port of call for many others.  It therefore seems desirable for the article to provide at least brief coverage of all aspects that are likely to occur to readers, if only in the form of links to other articles.  Relevant topics that don't seem to be covered at present include:   
a)  urination.  In the standard male anatomy, urine passes through the urethra down the centre of the penis and out through the opening (meatus) at its tip.  In the standard female anatomy, the urethra is a separate tube passing outside the vagina, and opening into the vestibule.  Urine does not normally pass through the vagina itself.  Neither of these arrangements seem to be possible with penile inversion, but I do not see any explanation in the present article of what *does* happen.  Is a separate opening created, or is the urethra included with the 'inverted' penis?  If the latter, urine presumably flows out through the 'vagina'.  If so, there must be practical issues of hygiene etc.
b)  semen.  In the standard male anatomy, seminal fluid is produced mainly by the seminal vesicles, stored in the prostate gland, and mixed with spermatozoa from the testicles at the time of ejaculation.  (Fluid is also produced by Cowper's glands at and before ejaculation.)  Ejaculation itself involves contraction of muscles around the relevant ducts. Obviously in the case of male-female surgery the testes are removed, so no spermatozoa are produced, but it isn't clear what happens to the rest of the apparatus, or to its functions. According to a comment on this Talk page, the prostate gland is usually retained, and I guess the same would apply to the other components - or are they removed to make space for the 'vagina'?  
c) ejaculation.   Assuming that the prostate and other glands are retained, seminal fluid will still be produced, unless perhaps production is suppressed by female hormones.   If there is orgasm, however induced (including 'wet dreams'), the seminal fluid is presumably released through the constructed 'vagina'.  
The present article may not be the place for detailed explanations, but I think these obvious major issues should at least be mentioned.2A00:23C8:7906:1301:AC7E:C960:BA3F:BB94 (talk) 15:48, 21 February 2021 (UTC)
thread_title:  Incompleteness of the article 

message: Prior to my changes, this article had many statements with no source attached, or sources that contradicted what was written in the article. One example of this is "Over time, dilation is required less often, but it may be required indefinitely in some cases." The citation for this was ". . . Dilation is required less often over time, but it may be recommended indefinitely.". As well, many of the unsourced statements were phrased in ways that could make gender-affirming surgery seem like haphazard medicine or inherently prone to poor outcomes, rather than a well-established medical practice no more or less prone to complications than any other practice:
"Surgeon's requirements, procedures, and recommendations vary enormously in the days before and after, and the months following these procedures." This statement is true, but it also is true for any other type of medical procedure. Its inclusion in tandem with other statements made implies gender-affirming care in particular is unorganised and unprofessional, which is a politically loaded and factually incorrect line of thinking frequently used to create legislation that denies trans people healthcare they need. I'm not saying anyone had bad intentions in writing this, but I don't think it needs to be here.
"Since plastic surgery involves skin, it is never an exact procedure." Again, while this is true, it isn't appropriate to include here.
"Supporters of colovaginoplasty state that this method is better than use of skin grafts for the reason that colon is already mucosal, whereas skin is not. Lubrication is needed when having sex and occasional douching is advised so that bacteria do not start to grow and give off odors." Not only does this statement present bowel vaginoplasty as needing "supporters" rather than being an established part of gender-affirming healthcare, it presents uncited information that makes bowel vaginoplasty out to be inferior or as making one "dirty" as fact. I found no references to foul smells as an outcome of bowel vaginoplasty during the research for the edits I've made so far. Perhaps I'll find the source for a statement like this as my research continues, but so far I haven't found it.
Many of the statements made originally, both unsourced and sourced with contradictory information, paint a strong picture of transfeminine genital surgery as being inherently prone to poor outcomes and resulting in a lifetime of discomfort at the best of times. As well, the structure of it is confusing at times. These issues are not present in the FtM equivalent of this page, so I am trying to bring this page up to that standard. Oystersauce99 (talk) 01:44, 22 September 2022 (UTC)
replies: text: Agree with most of what you have written, with the exception of the last sentence: there is no need to bring this page up to any other page present in Wikipedia; for one thing, Wikipedia is not a reliable source, so you cannot be sure that the other page is anything that should be emulated, and they are definitely not a standard. Better to just stick with your earlier comments about unsourced or contradictory information, and bring the article up to the standards of the policies and guidelines of Wikipedia, and you can pretty much ignore how they do it in the other article. Thanks for your comments, Mathglot (talk) 08:40, 22 September 2022 (UTC)
thread_title:  Overhaul and adding sources 

message: It seems Ingenuity already moved this article and Gender-affirming surgery (female-to-male) while closing the move to Gender-affirming surgery, although they missed out Sex reassignment therapy (not sure why) and they didn't move them to the titles were suggested (ie. Feminizing surgery and Masculinizing surgery). – Scyrme (talk) 18:53, 30 November 2022 (UTC)
replies: text: @Scyrme: I didn't move Sex reassignment therapy because the nominator suggested it should be merged with Transgender health care instead. I moved the FTM and MTF articles to the current titles to keep them consistent with the main article for the time being. Whether they should be moved to Feminizing surgery and Masculinizing surgery will need another RM to decide. — Ingenuity (talk • contribs) 19:04, 30 November 2022 (UTC)
thread_title:  After the move to [[Gender-affirming surgery]] 

message: Are any editors in favour of merging the subtopic 'History' with the homonymous subtopic in vaginoplasty? After all, the current section only focuses on vaginoplasty. As it doesn't seem feasible to write an entire history section on all gender-affirming surgeries, it may be a better idea to add a history section to the pages of the respective procedures and leave the rest of the page as it is. Cixous (talk) 19:23, 24 March 2024 (UTC)
replies: text: No, the history section in this article here focuses on surgery in the context of gender affirming care. The fact that the majority of this is Vaginoplasty is secondary to that. So the current article is the better location for the content. Raladic (talk) 15:21, 25 March 2024 (UTC)
replies: text: Thanks for your reply! Even if we want to keep the section, I'd say it does need rigorous rewriting, as it mostly focuses on the people receiving the vaginoplasty rather than vaginoplasty itself. Obviously both aspects belong to its history, but now the development history of vaginoplasty (or other gender-affirming surgeries for that matter) is largely left out. Cixous (talk) 13:19, 29 March 2024 (UTC)
thread_title:  History