Gender Affirmation Surgery (GAS)

What Is Gender Affirmation Surgery?

Gender Affirmation Surgery is a comprehensive set of surgical and medical procedures aimed at alleviating the incongruence between an individual’s sex assigned at birth and their experienced gender identity. These procedures seek to align a person’s physical appearance and bodily functions with their gender identity.

This process is not limited to surgery alone; it is a multidisciplinary treatment pathway that includes psychiatric evaluation, hormone therapy, and surgical interventions carried out in a coordinated manner.

Purpose of Gender Affirmation Surgery

The primary goals of gender affirmation surgery are to:

Achieve harmony between an individual’s gender identity and physical appearance
Improve psychological well-being and overall quality of life
Support social integration and personal satisfaction

Each patient’s treatment plan is individualized, and every stage of the process requires thorough and careful evaluation.

Who Is Eligible for Gender Affirmation Surgery?

In general, the following criteria are required for gender affirmation surgery:

A formal diagnosis of gender dysphoria by a qualified psychiatrist
Completion of a prescribed period of hormone therapy
Medical and psychological suitability for surgical intervention
Fulfillment of legal and ethical requirements

Legal procedures and requirements may vary from country to country.

Male-to-Female (MTF) Gender Affirmation Procedures

Common surgical procedures that may be performed during the male-to-female transition include:

Vaginoplasty: Creation of a functional and aesthetically natural vagina
Orchiectomy: Removal of the testicles
Penectomy: Removal of penile tissue
Breast augmentation surgery
Facial feminization surgeries (forehead, nose, chin, cheekbones, etc.)
Voice feminization procedures

These procedures may be planned as a single operation or carried out in multiple stages.

Female-to-Male (FTM) Gender Affirmation Procedures

Common surgical procedures performed during the female-to-male transition include:

Mastectomy (top surgery): Removal of breast tissue
Hysterectomy and oophorectomy: Removal of the uterus and ovaries
Metoidioplasty or phalloplasty: Construction of a penis
Scrotoplasty: Creation of a scrotum
Testicular prosthesis placement

The choice of surgical technique is determined based on the patient’s expectations, anatomical structure, and medical suitability.

Preoperative Evaluation Process

Before gender affirmation surgery, patients undergo:

Comprehensive medical examination
Psychiatric and psychological evaluation
Endocrinology consultation
Laboratory tests and imaging studies

Patients are thoroughly informed about the irreversible nature of the procedures, potential risks, and the postoperative recovery process.

Postoperative Process

Length of hospital stay varies depending on the procedure performed
Recovery may take several weeks to several months
Regular follow-up visits and supportive treatments are planned as needed
Long-term follow-up is essential

The ultimate goal is to achieve results that are both functionally and aesthetically satisfying.

Ethical and Professional Approach

Gender affirmation surgery requires a high level of ethical sensitivity, experience, and multidisciplinary collaboration. Each patient is evaluated with strict respect for privacy and dignity. Surgical decisions are made with the patient’s physical and psychological well-being as the highest priority.

Legal Procedures in Gender Affirmation Surgery (Turkey)

Legal Basis

In Turkey, gender affirmation surgery is not only a medical process but also a legal one. These procedures are subject to specific conditions under the Turkish Civil Code and related legislation. The aim is to protect the rights of the individual and to ensure that the process is carried out safely from a medical, psychological and ethical perspective.

The legal framework for gender change in Turkey is set out in Article 40 of the Turkish Civil Code. Under this article, certain conditions must be met and a court decision must be obtained before a person’s sex can be changed in the civil registry.

Conditions for Applying to the Court

To start the legal process for gender affirmation, the person must:

Be of legal age (18 years or older)
Not be married
Have medical board reports issued by specialist physicians documenting that gender affirmation surgery is medically necessary

If these conditions are met, the person applies to the Family Court.

Medical Board Report

The medical board report submitted to the court is usually obtained from an authorized state or university hospital with the following departments:

Psychiatry
Endocrinology
Urology / Obstetrics and Gynecology
Plastic, Reconstructive and Aesthetic Surgery

These reports aim to assess whether the person is psychologically and physically suitable for the process.

Court Decision and the Surgical Process

After reviewing the submitted reports and the application conditions, the court may grant permission for gender affirmation surgery. Once this decision has been obtained, the surgical procedures can be performed legally. Surgery performed without court permission is not legally recognized.

Change of Civil Registry Record After Surgery

After the surgical process is completed, a new application is made to the court together with the official surgical reports from the hospital and the relevant medical board documents.

If the court confirms that surgery has been completed, it orders the sex entry in the civil registry to be changed and, if deemed necessary, a change of name.

Important Information

The legal process must be initiated and completed before surgery
Each patient’s situation is evaluated individually
The process involves legal as well as medical responsibilities
Legal procedures may take time and require patience

For this reason, it is very important that patients are informed in detail before starting the process.

Our Clinical Approach

In our clinic, the gender affirmation surgery process is carried out based on:

Full compliance with legal regulations
Commitment to ethical principles
Respect for patient privacy
Multidisciplinary teamwork

Our patients are informed transparently and clearly at every stage of the process.