Sex Reassignment Surgery (SRS/GRS)
Male to Female Surgery
 According to The Harry Benjamin International Gender Dysphoria Association Inc.,(www…..), surgery is not a cure for Transsexualism. The best available treatment is a therapy program that includes surgery.
Surgery is more successful with patients already enjoying a life in their chosen gender role.
The requirement for SRS/GRS:
1. Should be of legal age in the patient’s nation. In Thailand, the father, the mother or the legal custodian may give consent for patients under the age of 18.
2. 12 months of continuous hormonal therapy.
3. 12 months of successful continuous full time real-life experience.
4. No serious medical or health issues.
5. Medical letters of recommendation for SRS/ GRS
The surgeon will evaluate each client individually, to determine if you are a good candidate for SRS/GRS.
The goals of male-to-female sex reassignment surgery:
1. To create female genitals as normal as possible.
2. To achieve adequate vaginal depth.
3. To ensure maximum orgasmic capabilities.
4. To minimize and hide scarring.
Sex Reassignment Surgery: Dr. Kamol’s current technique
Dr. Kamol's standards for performing SRS/GRS from male to female are as follows:
1. Highest safety during the operation process.
2. The creation of a functional vagina with normal sensations and feelings.
3. External appearance as close as possible to a genetic female, with less noticeable scarring.
4. Less postoperative pain after the surgery.
5. Patients usually recover quickly and return to their normal routine.
Our nursing staff will provide excellent post-op care. After the surgery, they will perform the necessary care and do the dilation until your departure. This will be done twice a day.
We also extend our sincere friendship to you and hope you will keep in touch with us and let us know of the progress in your new life. We feel this will help our patients both physically and emotionally towards a speedy recovery.
Dr. Kamol offers three SRS/GRS procedures:
1. Penile Skin Inversion:
This procedure is suitable for patients who have sufficient penile skin. The skin of the penis is inverted to create a vagina. The glans prepuce complex with its nerve supply is used to create the clitoris, therefore maintaining normal sexual sensation. The scrotal skin is used to form a full-thickness graft to give extra depth to the vagina.
2. Non-Skin Inversion:
The inner labia and clitoris is constructed from the glans and penile skin. The outer labia is constructed from scrotal skin, and the vaginal wall is constructed from scrotal skin graft. The patient does not need to have a hair removal treatment before surgery because the genital hairs are scraped from the skin graft.
3. Non-Inversion with skin graft from other area:
A section of the recto-sigmoid colon is used to create the vagina. The colon serves as a self lubricating vagina. The scar resembles a C – section surgery.
Sequential intermittent Compression Sleeves
The advantage of Male-to-Female SRS/GRS using
Dr. Kamol’s GRS/SRS unique technique
- Single stage procedure.
- Very minimal scarring.
- A much shorter exterior scar that is well hidden.
- Ability of patient to wear G-string when healed and look like a genetic female.
- More sensory tissue is kept and used to create female genitals.
- To create a vagina that is aesthetically close to the natural one.
- A labia majora and labia minora aesthetically close to the natural one.
- Excellent vaginal depth of approximately 5 - 7 inches.
- More fullness of mons pubic.
During the clinical consultation, you will be interviewed and your health evaluated to determine if you are a good candidate to undergo SRS/GRS. The quantity and quality of skin will be examined to evaluate the vaginal depth.
Recovery after surgery
Pain:
After you recover from the anesthesia you may feel some pain but it is minimal and usually it lasts for a brief period of time and will gradually subside. You will receive IV fluid and some antibiotics.
Tube drains and catheter:
The tube drains and the urinary catheter will be left in place for 4-6 days. After the catheter is removed, you will be able to urinate on your own while sitting..
Food:
You will be able to have drinks and soft meals in the first few days and to have regular meals after you are able to have bowel movement.
Hospitalization
The postoperative period will require a 6 day stay in the hospital. After the vaginal packing is removed you will be able to walk carefully and slowly, usually around day 4. During your stay in the hospital you will be cared by the hospital nursing staff.
Postoperative care at our clinic:
Upon leaving the hospital you will start the post-op care at our clinic facility, under the care of the clinic nursing staff.
We recommend an additional 14 + days stay in Thailand, to recover and to be able to travel a long journey.
We recommend the client to stay at a hotel close by our clinic as you are required to come to the clinic twice a day for dressing and dilation.
Travel arrangements:
We recommend the client to arrive here 3 days prior the surgery date. This will give you time to rest, to consult with the surgeon and, if required, to undergo additional tests.
If you plan to do some sightseeing here, we recommend that you do so before undergoing the surgery. After the surgery you will be more limited and we do not recommend you going on long walks as it might cause swelling and discomfort. In this case, we suggest you to include extra days in your travel arrangements.
Vaginal dilation:
It is necessary to start to gently dilate your vagina two times a day, for the first couple of months, for about one hour each time, with an adequate amount of lubricant gel. The need to dilate becomes less frequent over time, particularly if you regularly engage in sexual intercourse. In case of no sexual intercourse after six months, the dilation for the vagina is needed twice a week.
The importance of dilation and post-surgical care:
Dilation is the most important task you must do to ensure the success of your surgery. If you do not dilate responsibly, this can result in the shortening of depth and vaginal stenosis, including partial to total collapse.
Failure to properly dilate in the early stages can result in patients experiencing excessive vaginal pain at late times. In order to achieve more depth and to avoid vaginal obstruction it is very important that you follow the dilation instructions accordingly.
You will be instructed on proper and gentle dilation technique after the vaginal packing is removed. Dilation is essential for developing maximum depth and ensuring post-op functionality of your vagina.
Dilation:
A few days after the packing is removed you will begin the process of dilation of your vagina, at our clinic. You will be given a set of 6 dilators of different sizes. These dilators are graduated in small increments from just under 1 inch to 11/4 inches in diameter. You start with the smallest dilator and every 7 -10 days you will move to the next size until you reach the largest size.
It is recommended to dilate twice a day, for 60 minutes each time, for the first 3 months. After that you can dilate once a day, for a few months, tapering off to 2 - 3 times a week. This is flexible and depends upon your age and if you have a sexual partner.
To prepare for dilation you should urinate or have a bowel movement prior to starting. This can make the dilation more comfortable.
Expectation after the surgery
Sexual Intercourse:
After the 3rd month post-op, you should be able to engage in normal vaginal intercourse. We recommend using gel as a form of lubrication. If you are healing well you can engage in intercourse after 2 months.
In general, patients may engage in sexual intercourse after they get to dilator number 6.
Return to female hormones:
Patients can resume taking female hormones in 10 – 14 days after the surgery but the need for hormones is less than prior to surgery, about 1/2 to 1/4 of preoperative doses.
Before returning to hormones it is recommended that you check with our surgeon first. Our clinic director can assist you on what types and doses should be taken.
Legal matters
Medical Certificate:
After the surgery, you will receive a Medical Certificate, given by the surgeon, stating that you have successfully undergone Sex Reassignment Surgery. It is of the client’s responsibility to provide us with the necessary information to be included in the certificate to meet the requirements of your country for legal purposes.
The process for legal name change and birth certificate amendments as well as other registered documents, is the responsibility of the client and it should be done in the client’s country according to its laws and regulations.
Concierge services:
- Hotel reservation
- Transportation: Airport/Hotel/Airport
- Tourist information
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