Gender Reassignment Surgeries

The most common complaints by my patients are that the person determines his/her social life like the opposite sex, unlike the genetic structure to which he/she belongs, and that he/she does not belong to the body he/she is in. As a Plastic Surgeon, I do not have the ability to explain here the psychological and psychiatric background, which is a subject in which I am not an expert, why this internal structure is formed like this and why these people feel this way. I can give you the necessary information about the surgery and legal procedure of sex reassignment surgeries, which is what I do best.

First, legally, surgeons cannot perform surgeries that will change the gender of anyone who wishes. Because in these surgeries, the reproductive function suitable for the genetic structure of the person is permanently removed. For this reason, this operation imposes very serious legal obligations on the surgeon and they can be prosecuted under the provisions of the Turkish Penal Code due to unauthorized procedures. Then let me explain what kind of process is the legal way. Of course, after all, I am not a lawyer, but as a member of the gender identity council, I have some information as I am constantly dealing with these procedures and our responses to the courts. First, the person has to apply to the court with this request to change their gender and change their identity from pink to blue or from blue to pink. Subsequently, the court judge requests that the person apply to official institutions such as Hacettepe University, which has a sexual identity council, in order to fully reveal the sexual identity of the person and to understand whether he or she is transgender. Gender identity council is available in several university hospitals in Turkey. This council includes Psychiatry, Obstetrics, Urology, Endocrinology, Plastic Surgery and lawyers. However, the most dominant decision-making authority in this council is psychiatrists, as can be expected. Psychiatrists sometimes follow the applicant for up to two years. Here, he is investigating whether the patient’s gender identity and genetic gender identity are appropriate. In the meantime, the patient is provided with hormones suitable for the gender he wants to change by endocrine and changes in his body are provided. In this way, important findings are obtained as a result of this endocrine treatment, whether the person really wants to be the opposite sex or not. As a result, this treatment is reversible and if the patient gives up the sex change process, the drugs are discontinued and he returns to his previous state. If the psychiatrist decides that the sexual identity of the person is of the opposite sex, he/she brings these people to the gender identity council, where the final decision is made after being re-evaluated by the sections I mentioned before. If the council decides that sex change is appropriate for the patient, the judge evaluates this result and allows a series of operations that will cause permanent loss of reproductive function and new genitals will be made. With this permission, the person can go to the institution or doctor of his choice and have these surgeries. Later, she applies to the court again and declares that she has had sex reassignment surgeries. The judge of the court may request that the patient be examined in a full-fledged hospital to see if these surgeries were performed at this time. When the doctor’s report that the person has had sex reassignment surgeries reaches the judge, the court allows the person’s identity card to be issued in accordance with the opposite sex.

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