Autor*innen: Isabelle Melcher & Kai Jannik
Seeing a therapist while transitioning is unfortunately, as described above, still a prerequisite in order for health insurance providers to assume the costs for all further medical measures – this is why therapy starts at the beginning of the medical transition. Nonetheless, it would be desirable for therapy to take place on a voluntary basis in future.
Hormone Therapy and/or Puberty Inhibition:
For many trans* people, the start of hormone treatment (taking hormones of the desired gender) is an important milestone. Over the course of hormone treatment, the first physical characteristics change towards those of the desired gender. For young people at the beginning of puberty, the option of hormonal puberty inhibition is a feasible intermediate step to ensure that the individual’s level of suffering doesn’t worsen. While the process of inhibiting puberty is reversible, hormone treatment entails changes that are irreversible or not so easy to reverse after a certain amount of time. Both should always be carried out under medical supervision.
Gender Reassignment Surgery(ies)
The term gender reassignment surgery is used to describe various surgical interventions to adjust the body to its gender identity. Some of these procedures are briefly elaborated upon here. There are however other possible options and various surgical procedures. It is important to always be well informed about the respective interventions and procedures, and, where possible, it is recommended to visit several clinics for a first opinion.
Mastectomy (for trans* males): This refers to the readjustment of the male breast. There are basically two different procedures. The choice of procedure also depends on the breast size of the person in question.
Breast Surgery (Breast Augmentation) for trans* females: The costs for this surgery are only borne by the health insurance provider if an established suffering has been proven in the patient. Whether the breast has already grown somewhat through hormone use also plays a role here.
Hysterectomy: This refers to the surgical removal of the uterus. This procedure is carried out in conjunction with the removal of the ovaries and fallopian tubes. In many cases this procedure is also undertaken to reduce the risk of cancer during ongoing hormone treatment.
Phalloplasty: Forming a male phallus (penis). There are several methods that differ in terms of appearance, difficulty of operation and procedure. This procedure is often combined with testicular plastic surgery. It is recommended that you read up on the various methods and outcomes before undergoing a procedure.
Vaginoplasty: Reconstruction of the female genital organs. In this case there are also several options that differ from one another specifically. The aim here is to achieve the most authentic look possible.
Epilation Treatment: Removal of body hair using various methods. (Laser and light therapy procedures, electrolysis or needle epilation procedures). In the case of trans* females, the removal of facial hair is covered by health insurance providers, once all requirements are met.
Vocal Cord Surgery: Various surgical techniques with the aim of changing the voice to a female sound profile. This operation is risky and results are only partially expectable. For this reason, the alternative of speech therapy (voice therapy) should be exhausted first.
Facial Feminization: This term encompasses a whole series of surgical interventions in the facial area, all of which aim to achieve a “more feminine” appearance. If such procedures cannot be confirmed to be medically or therapeutically necessary, they fall under the term “cosmetic surgery” and must then be paid for accordingly.
Further Complementary Measures:
Speech Therapy: Voice Therapy with the aim of adjusting the voice profile to that of the gender identity.
Epitheses: Aesthetic “prostheses” that replicate the female breast or male phallus.
Wigs: If justified, the costs are to be borne by the health insurance provider.
Last updated: 02/26/2021 - 11:06