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CHECK Bayern #1

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Die erste Ausgabe des Männer*Gesundheitsmagazins für Bayern

TRANS* ENGLISH SEX

TRANS* ENGLISH SEX REASSIGNMENT SURGERY „Munich is a Mecca“ Interview: Bernd Müller For trans* people, arriving at the gender identity they feel is the right one for themselves can take a long time. Patricia Sophie Schüttler is a trans-woman herself and assists in gender reassignment operations. We talked to her about the physical and mental aspects of such interventions. Which operations are more difficult: Male-to-Female or Female-to-Male? It‘s hard to say in general terms. Male-to-female alignments require fewer steps and can be completed with two surgeries. But they also seem more dangerous to me, because when you create the neo-vagina you are dissecting deep into the body. The adjustment from female-to-male, on the other hand, is more complex with at least five steps, but can also require significantly more interventions: It starts with the masculinizing breast surgery (mastectomy), followed by the removal of the ovaries and uterus and closure of the vaginal cavity and adding of a so-called clitpen (clitoral penoid). This is followed by the construction of the penoid, modifying measures and finally the installation of a pump or similar systems that enable an erection. What health risks do trans* people face? The classic risks such as infections, swelling or bleeding are known and are the same as with any operation. In male-to-female surgery, bowel or bladder injuries can occur. In rare cases, there is the risk of incontinence or the inability to experience an orgasm. In femaleto-male surgery, the breast can become numb after the mastectomy. Large sections of skin required for the creation of the penoid are taken from the arm or thigh and can leave large scars. Lengthy physiotherapy is then required in these areas. Fistulas or diverticula also often occur in trans* men on the newly created urethra. In the worst case, poor blood circulation can lead to a (partial) loss of the penoid, especially in the beginning. Implanted prostheses always involve the risk of infection and wearing out. What is life like with new genitals? Immediately after the operation, trans* men are not allowed to get up for a few days, because the penoid must first grow in peace. The treatment can take several years until all operations are completed and requires a lot of care and patience on the part of the patient. For trans* women, the focus is on stretching the new vagina (bougienage) in the first few months following the operation. You do this two-to-three times a day. The frequency decreases over time, but in principle remains necessary for a lifetime — unless you are sexually active and thereby replace bougienage. Does gender reassignment surgery make you happy? I find it difficult when people believe that the operation will turn them into a “real” man 18 CHECK BAYERN #1

TRANS* or a “real” woman. It does not work like that. Even when you‘re done, society still might not accept you. Then comes the frustration. The image that some trans* people have of the desired gender is an optimal image of the opposite sex and may even have a sexist touch. A purely external self-optimization will rarely succeed. Psychologically, it can also happen that your trans* issues accompany you for a lifetime. That, too, can be stressful, because you actually wanted to arrive, you wanted to be finished and at some point you realize that your desire for „normality“ may never be 100 percent fulfilled. Not only the body, but also the soul has to adapt to the new situation — and that can take time. Foto: Lena Balk/unsplash.com Does it happen that people want to be operated back? The cases of a so-called de-transition are probably in the per mil range — fortunately, because otherwise the health insurance companies would no longer cover such treatments. Those who undergo gender reassignment surgery are not only cognizant of the physical change, but are mentally and emotionally prepared for the journey ahead. To make sure of that there is the so-called “everyday test”, in which the person should try out their new role over many months as well as undergo multiple psychiatric evaluations. All of this is to ensure that the path is right for the person. This psychological support is reassuring, especially for parents, since more and more young trans* people are choosing this path. Is Munich a good place for trans* people and gender reassignment surgery? Definitely. We have three clinics that operate in both directions with excellent reputations. There are several self-help groups here, as well as institutions funded by the city, such as the Trans*-Inter*-Beratung (counseling center). Last, but not least, the “Qualitätszirkel Transsexualität” meets in Munich, where experts exchange ideas with each other as well as trans* groups and relevant institutions. My conclusion: Munich is not just a good place, it is a Mecca! (translation: ts,sw) Patricia Sophie Schüttler (48) Foto: Sonja Lubos is a trained dentist and now works as an operating room assistant in a Munich clinic that has opened one of the first transgender centers in Germany in 1997 and performs around 1000 interventions on trans* people per year. Patricia is the 2nd chairwoman of the national association Trans-Ident e.V. and heads its self-help group in Munich. She is also involved in the Munich education project, which provides information about LGBTIQ* in schools, and is active in the CSD (Munich Pride). Patricia Sophie has been married since 2003, underwent gender reassignment surgery in 2015 and lives with her wife in Munich. CHECK BAYERN #1 19

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