Within the framework of the annual meeting of the Galician Society of Plastic, Reconstructive and Aesthetic Surgery, Dr. Oihane García presented in yesterday’s conference held at the Attica21 Hotel the presentation entitled “Genital feminization surgery: its adaptations based on clinical experience ».
–Catalonia is a reference in sex change surgery at the state level, what are the steps to start the process?
-In Primary Care centers there are consultations called Trànsit and this is where all trans people and their families go, those who have doubts, who do not know if they are trans or not and need support or a professional to explain to them. the process. From there, if the people who come express their desire to perform the surgery, then they are referred to one of the three hospitals in Catalonia that deal with this type of intervention. Once referred from Trànsit, the plastic surgeons perform an examination, ask about their background, explain what the surgery is like, pros and cons, as well as the technique we are going to use. If at this point they agree, they enter the waiting list and, once the surgery is done, we monitor their progress for a year and then they return to Primary for check-ups.
-Is the waiting list high? What attention times do they handle?
-Yes, the waiting list is long. Right now, in our hospital, of all the girls we have seen, we are scheduling surgeries for 2027. What happens is that when they arrive to us, after having gone to the Servei Trànsit, they normally already have a year to wait, it could be two or four, on other occasions.
-Has demand increased in recent years? What volume of patients do you currently see?
-In Catalonia, right now, we are carrying out 70 vaginoplasties a year between the three hospitals. In my center, at the Germans Trias i Pujol Hospital, we are carrying out approximately 25 a year. The Bellvitge Hospital has the same number, while the Hospital Clínic is carrying out about 20. Regarding the increase, there has been an increase. Before 2019, only the Hospital Clínic performed this type of surgery and it used to do about 15 a year. In 2019 we and the Bellvitge Hospital joined forces, which last year were at 20 and in 2024 they have increased to 25. On the other hand, there is no territoriality, patients arrive from all over.
-What is the surgery like?
-In the vast majority of vaginoplasties, everywhere in the world, the surgery is always the same. The clitoris is built with the glans, the hood and labia minora with the foreskin, the labia majora with the scrotum, and the vaginal tunnel is made between the urethra above and the rectum below. The great crux of the technique is which skin is chosen to cover the vagina, because if we only left the gap, it would close. You have to choose a specific skin type and I always recommend, if the characteristics meet, performing a penile inversion.
-What is the degree of satisfaction once the intervention is completed?
-The degree of satisfaction is great. I know that sometimes people who, in quotes, regret having had surgery, resonate a lot everywhere, but personally, of the patients I have treated I have not met any, although it can happen. In addition to this type of surgery, I also deal with melanoma surgeries, perform reconstructions after breast cancer, facial fractures and other reconstructive surgery, but without a doubt, my most satisfied patients are the trans girls to whom I perform vaginoplasty. By far, they are the patients who are most grateful when they come for subsequent consultations, they arrive very happy and always leave giving me a hug.
-And what consequences would there be for not doing it?
-I believe that in an ideal ideal world, in what I think is a utopia because we are very far away, the ideal would be for a girl to be able to express that she is trans and to be able to do so freely without the fact of having a penis or not transcending or I would put some limitations on you. Deep down, I think that the ideal would be for them not to need surgery, for them to be able to live their lives without having to undergo surgery, which in the end is high surgery. But I think we are still very far from that ideal as a society, because then, on a daily basis, situations arise such as going into the sea with a bikini and when you come out, checking yourself, wearing tights in the summer or deeper issues like having a partner. or be with family, because, although this is cruel, not everyone is going to accept you with your genitals. It is very complex.
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