12 June 2009

Cher's daughter has sex change

Chastity Bono is having a sex change to become a man.

Chastity Bono is having a sex change to become a man.

A spokesman for the daughter of Sonny and Cher says Bono "has made the courageous decision to honour his true identity" and began the sex-change process earlier this year.

Publicist Howard Bragman says Bono "is proud of his decision" and hopes "that his choice to transition will open the hearts and minds of the public regarding this issue."

The 40-year-old writer, activist and reality-TV star came out as gay 20 years ago.

The following procedure is usually followed when a woman undergoes a sex-change to become a man:

Hormonal treatment
The female to male (FTM) person will usually seek hormonal treatment as the first step towards their new body. A prescription is needed to get testosterone for the FRM, which is the masculanising hormonal therapy.

An endocrinologist writes the prescription, and monitors how your organs are coping with the testosterone once treatment has begun.

Some of the changes from testosterone are permanent and irreversible, while others are maintained only through continuous use.

What happens?
Each person who takes testosterone reacts to it and experiences it differently on an emotional level. You will not know how you will react to the treatment until you start it yourself.

Physically, the changes that occur are generally the same for everyone. However, it is important to be realistic about your body, and expect the changes to be in proportion to how your body looks at the start.

The permanent changes include a deepening of your voice; increased body hair on your thighs, abdomen, back, arms and chest; facial hair; receding hairline and possible baldness; Adams apple and facial bone thickening; enlargement of clitoris; and your skin becomes coarse.

The changes that are not permanent, and which will go away if you should stop taking testosterone include decrease of fat in buttocks, breasts and thighs, and an increase in fat on abdomen; an increase in red blood cells; increase in ability to grow muscle; increase in sex drive; weight gain; and menstruation ceases.

Testosterone will not grow you a penis or make your breasts disappear. The changes that do occur are slow, and depending on your dose, will take from a few months to up to five years to complete. Testosterone is not a birth control measure, and you can fall pregnant if your female genitals come into contact with sperm.

Risks associated with testosterone use include liver damage; increased risk for breast cancer, even after top-surgery; increased risk for uterine cancer.

Chest surgery during a sex change
Following hormonal treatment, the next step is usually top surgery (chest surgery). There are many different methods for performing this surgery, and is often determined by the results you want, and the size of your breasts. Your therapist will be able to put you in contact with a surgeon.

The options for chest surgery include: keyhole, drawstring, pie wedge, and double incision.

A hysterectomy is also often undergone, in order to remove all high risk cells that could become cancerous due to testosterone intake.

FTM genital reconstruction
The last surgery that is undergone in female to male (FTM) reassignment treatment journey, and which is undergone by very few FTM transsexuals, is bottom surgery.

As with the case of top surgery, there are different techniques. Many FTMs don't opt for bottom surgery, as the surgical techniques are not very advanced, and there is more to being a man than the presence or absence of a penis.

Genital reconstruction is a lot more expensive and has far greater risks than top surgery.

Two options
Genital reconstruction falls into two basic types: phalloplasty and metoidioplasty.

The more contemporary phalloplasty technique is called the free tissue flap transfer (FTFT). This technique has been made possible by the advent of microsurgery, and the development of the fine art of connecting dissimilar nerves. A flap of skin and muscle tissue from the forearm, groin, or thigh, is transferred with its existing nerves and blood vessels to the groin area, and then microsurgically connecting the nerves and blood vessels to the nerves and blood vessels of the groin.

This results in a penis that may have feeling, but is not capable of achieving or sustaining an erection. Although implants are available to achieve erection, they have so far proven to be problematic due to infections, rejection by the body, and extrusion and intrusion.

The metoidioplasty technique is the other available technique for creating a penis-like structure on an FTM. This technique uses the clitoris, and transforms it into a more male-looking structure, providing there has been sufficient clitoral growth induced by testosterone. The process involves the release of the clitoris, which basically means that the ligaments that hold the clitoris in a position are severed. The result is a micro-penis. The scrotum is formed by joining the labia majora and using silicone testicular implants, sometimes preceded by tissue expanders.

This procedure allows the FTM to have a penis that is normal in appearance, with a natural glans and foreskin, as well as the appropriately sized scrotum. Sexual function is retained, and the FTM can have natural erections and orgasms.

- (Sapa/Health24, June 2009)

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