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Gender-Affirming Surgery: Male to Female
Kyle K. Jensen, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Transgender and gender diverse (TGD)
            • Gender-affirming surgery (GAS)
            • Transfeminine (TF)
            • Penoscrotal inversion vaginoplasty (PIV)
          • Synonyms

            • "Top" (chest/face) and "bottom" (genital) surgeries, colloquially
            • "Transgender" used as adjective, never as noun
            • Transgender women: Transwomen, transfeminine, male to female
            • Offensive terms no longer used: Sex change, sex reassignment surgery, gender reassignment surgery, gender-confirming surgery
          • Definitions

            • TGD persons: Gender identity discordant with biological sex
              • e.g., persons with male sex at birth with female gender identity = transgender women
              • Gender dysphoria: Distress caused by this incongruence
            • Goals of GAS
              • Aligning anatomy with gender identity to relieve gender dysphoria
              • Ability to engage in receptive vaginal intercourse
            • Transfeminine GAS
              • Top: Facial feminization, thyroid chondroplasty (i.e., tracheal shave), voice surgery (e.g., glottoplasty, cricothyroid approximation), breast augmentation
              • Bottom: Penectomy, orchiectomy, PIV
              • Less common: Enteric vaginoplasty, peritoneal flap vaginoplasty

          IMAGING

          • Mammographic Findings

            • Fluoroscopic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      CLINICAL ISSUES

                      • Demographics

                        • Feminizing Procedures

                          • Complications

                            DIAGNOSTIC CHECKLIST

                            • Image Interpretation Pearls

                              • Reporting Tips

                                Selected References

                                1. Hassan O et al: Imaging in gender affirmation surgery. Curr Urol Rep. 22(2):14, 2021
                                2. Parikh U et al: Breast imaging in transgender patients: what the radiologist should know. Radiographics. 40(1):13-27, 2020
                                3. Shoureshi P et al: Penile inversion vaginoplasty technique. Urol Clin North Am. 46(4):511-25, 2019
                                4. Stowell JT et al: Imaging findings in transgender patients after gender-affirming surgery. Radiographics. 39(5):1368-92, 2019
                                5. Gao Y et al: Male breast cancer in the age of genetic testing: an opportunity for early detection, tailored therapy, and surveillance. Radiographics. 38(5):1289-311, 2018
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Clinical Issues

                                      • Diagnostic Checklist

                                        TERMINOLOGY

                                        • Abbreviations

                                          • Transgender and gender diverse (TGD)
                                          • Gender-affirming surgery (GAS)
                                          • Transfeminine (TF)
                                          • Penoscrotal inversion vaginoplasty (PIV)
                                        • Synonyms

                                          • "Top" (chest/face) and "bottom" (genital) surgeries, colloquially
                                          • "Transgender" used as adjective, never as noun
                                          • Transgender women: Transwomen, transfeminine, male to female
                                          • Offensive terms no longer used: Sex change, sex reassignment surgery, gender reassignment surgery, gender-confirming surgery
                                        • Definitions

                                          • TGD persons: Gender identity discordant with biological sex
                                            • e.g., persons with male sex at birth with female gender identity = transgender women
                                            • Gender dysphoria: Distress caused by this incongruence
                                          • Goals of GAS
                                            • Aligning anatomy with gender identity to relieve gender dysphoria
                                            • Ability to engage in receptive vaginal intercourse
                                          • Transfeminine GAS
                                            • Top: Facial feminization, thyroid chondroplasty (i.e., tracheal shave), voice surgery (e.g., glottoplasty, cricothyroid approximation), breast augmentation
                                            • Bottom: Penectomy, orchiectomy, PIV
                                            • Less common: Enteric vaginoplasty, peritoneal flap vaginoplasty

                                        IMAGING

                                        • Mammographic Findings

                                          • Fluoroscopic Findings

                                            • CT Findings

                                              • MR Findings

                                                • Ultrasonographic Findings

                                                  • Imaging Recommendations

                                                    CLINICAL ISSUES

                                                    • Demographics

                                                      • Feminizing Procedures

                                                        • Complications

                                                          DIAGNOSTIC CHECKLIST

                                                          • Image Interpretation Pearls

                                                            • Reporting Tips

                                                              Selected References

                                                              1. Hassan O et al: Imaging in gender affirmation surgery. Curr Urol Rep. 22(2):14, 2021
                                                              2. Parikh U et al: Breast imaging in transgender patients: what the radiologist should know. Radiographics. 40(1):13-27, 2020
                                                              3. Shoureshi P et al: Penile inversion vaginoplasty technique. Urol Clin North Am. 46(4):511-25, 2019
                                                              4. Stowell JT et al: Imaging findings in transgender patients after gender-affirming surgery. Radiographics. 39(5):1368-92, 2019
                                                              5. Gao Y et al: Male breast cancer in the age of genetic testing: an opportunity for early detection, tailored therapy, and surveillance. Radiographics. 38(5):1289-311, 2018