Transition and gender-affirming surgery

June is the month dedicated to Pride and to LGBTQI+ awareness, including what transgender people suffer, who often feel trapped in a body that is not theirs.

In recent years, gender-affirming surgery has become advanced and is now safe and effective, especially when done at the end of hormonal and psychological therapy. Today, those who want to affirm their gender have full support by surgeons and psychologists; however, transgender people still have to face discrimination.

Surgery and medicine to match gender and sex

According to research from the Pew Research Center, in the United States 1,6% of adult people is transgender. People who are a different gender than the one assigned at birth often suffer discrimination and misunderstandings. Luckily, medicine and psychology are making strides to help transgender people. The first surgical operations draw back to the first years of 1900; now, patients need to undergo hormonal, psychological and eventually surgical therapy.

The full procedure has been long studied by doctors, until it stopped being a niche field and started being taught at universities. «Today, education of future doctors, psychologists and nurses, namely healthcare professionals, cannot avoid confronting these topics» professor Paolo Valerio, president of the ONIG (National Observatory of Gender Identity), explains.

Transgender people are still subjected to severe social discrimination, and sometimes even legal ones. «The nefarious elements of our culture are stereotypes and prejudice» Valerio states. «The evil offspring of this couple is stigma, which can give way to homophobic and transphobic behaviours». Nonetheless, medical techniques that allow transgender people to find themselves in a body they feel theirs still advance. One of the most innovative surgeries is the one that modifies the voice’s pitch.

Giving the right voice to those who need it

«My patients do not say they have the wrong body, they say they have the wrong clothes» Andrea Luigi Cavalot explains. Cavalot, otolaryngologist, Director of the Otolaryngology Clinic and Director of the Surgical Area of the Local Health Authority ASL TO5, is an expert in operating vocal chords in transgender people who have started a transition therapy. The surgery, which was initially discovered by a Japanese surgeon, has been perfected by Cavalot making it reversible and with a lower chance of complications. «The surgery may be reverted to make the vocal chords the same as they were in the beginning. However, nobody has ever asked me to do it.»

This is why the procedure can be conducted soon after the start of hormonal therapy. The importance of having a voice that matches the gender identity is high, as Cavalot has operated on more than 500 people, and his centre is an Italian excellence. «Some people, especially those who are not educated on the matter, do not understand why I do this surgery, and they say I should not use public resources to execute it» he explains, as the procedure is covered by the National Health Service. «What they do not understand is that for them changing voice is not a pet peeve, it is a necessity.»

As professor Valerio puts it, living in a body that feels right is the basis of a humane life. This is why gender-affirming surgery is the answer for transgender people. «We need to give all people their chance at living a good, happy life, without basing our behaviours on prejudices that have absolutely no validity nor ethical, moral and scientific foundation.»