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A sex change is quite a major transformation, so making the necessary alterations requires a fair bit of skill. There is no formal education about this type of surgery in Medical Schools. SO, every surgeon doing this type of surgery has their own technique.
This eye-opening video, created by the European Society of Urology, provides a detailed look at the key surgical procedures involved in male-to-female gender reassignment, whereby the penis and testicles are used to create a vagina that is not only convincing to the eye, but is also capable of orgasm.
As the animation below shows, the procedure begins with the opening of the scrotum in order to remove the testicles, followed by the separation of the glans – or head of the penis – from the main shaft. Since this is the part of the penis that contains the most sensory nerve endings, it is later used to create a neoclitoris.
The skin of the shaft and scrotum are then used to create the labia and vaginal canal, with many patients going on to enjoy an active and fulfilling sex life.
Of course, a male-to-female sex change involves more than just the conversion of the penis and testicles into a vagina, and begins with a series of emotional and lifestyle readjustments. The prospective patient is often required to live as a woman for a period of time before undergoing surgery. This is followed by a course of hormone therapy, using estrogen and anti-androgens (androgens are male sex hormones like testosterone) in order to alter the patient's musculature and fat distribution, as well as their body hair, thus creating a more feminine figure and appearance.