“Be sure that it is what YOU want and do not do it because you have to know its irreversible. You can fix some things, but you have to go through a lot. Look at the reality and the effects. Weigh your options and do your homework yourself. Be your own advocate. Know what, how, and what the healing process is. Most important learn the side effects.”


In addition to hormone therapy, transgender women can choose to alter their body surgically; there are several elective procedures someone can undergo to continue to align their physical selves with their gender identity. This collection of surgeries is often called transgender surgery or gender affirmation surgery but may be referred to by outdated terms including gender reassignment surgery, sex reassignment surgery or sex change operation.

The following is a list of surgeries someone may choose for their personal surgical transition.

Top surgery

Colloquial phrase to describe gender affirming surgery of the chest — either bilateral mastectomy or breast augmentation.

Breast Augmentation

This surgery, also known as a Boob Job, gives the chest a feminine appearance by placing either silicone or saline implants under the breast and muscle tissue of the chest to create (larger) breasts.  Some people also get additional breast fullness in specific areas from fat grafting that comes from the belly, hips or thighs.

Facial Feminization Surgery

This is a general term for many types of surgeries to change characteristically male facial features and bring them closer to typical female facial features. These include but are not limited to brow/forehead lift, Rhinoplasty or Nose Job, Cheek Implantation, Lip augmentation and Chondrolaryngoplasty or Tracheal shave, which reduces the size of the Adam’s Apple and gives a person’s neck a more feminine appearance.

Vocal Feminizing Therapy and Vocal Surgery

Vocal surgery is designed to raise the pitch of one’s voice closer to an average feminine range along with speech therapy to teach new communication behaviors for modifying the voice and speech patterns to avoid damage.

Another common cosmetic procedure that is common for Transgender Women and Femme individuals is hair removal for face, chest and genitals. There are two ways that more permanent hair removal can be achieved, laser and electrolysis hair removal.

Laser Hair Removal

The laser that is used in this procedure delivers a small amount of radiation to the hair follicle to disrupt the hair growth. The laser can hit more than one follicle at a time, so people may see quicker results from laser hair removal. The laser only disrupts hair growth, so without continued maintenance, hair will regrow over time.

Electrolysis Hair Removal

A small probe is inserted into the hair follicle that’s sends an electrical shock into the follicle to kill the follicle permanently.  Electrolysis is the only FDA approved hair removal for permanent results. It is recommended that you only go to a licensed cosmetologist or electrologist for treatments. This may require more sessions for overall permanent results.


(Pronounced or-key-EK-tuh-me): This surgery removes the testicles and is often chosen as initial transition surgery. By removing the testicles, this reduces the amount of testosterone produced by the body which can lead to potentially simpler hormone regimens for transition.

Bottom surgery

Colloquial phrase to describe gender affirming genital surgery.

Vaginoplasty/ Vaginal construction

Surgery which transforms the male genitals (penis and scrotum) into a vagina and vulva and repositions the urethra so a person can urinate.

“My personality helps me with who I am and the woman I am. I am girly. My drag persona is really large and all extra. I do not personally need that. Also, if I never have surgery that is fine.”


“I think that even when I identified as a man, I was an effeminate man, so when I became trans my body had to match that representation. I had breast augmentation to move forward in identifying as a female.”