Surgeon explains difficulties of transitioning genders


(Editor’s note: This story is the second part of a multi-part series “Identity Crisis,” examining the transition from one gender to another that begins in Issue #1 and will continue through Issue #6. Several staff members took it upon themselves to interview, take photographs and conduct research. The results of their combined efforts follow.)

by: NICOLE TRUGILLO/Editor-in-Chief

Being different is hard. It’s even more difficult when someone is identified as being transgender.

Transgender people have a hard time showing their true individuality. It’s even harder when they are in the process of transitioning from male to female, or female to male.

According to Dr. Michael Eisemann, who is a plastic surgeon located out of Houston, Texas, after the surgeries, his transgender patients have more confidence and are happy with their results.

“The patients are very gratified and happy when they’re done with the surgery,” Dr. Eisemann told the Plainsman Press in a recent interview. “There have been some patients, in my practice, that have been on medication for anti-depression, even medication that helps with suicide. But basically, patients could not receive any help once they had the surgery. They are much better off getting these medications. We recommend that they continue to be treated and followed by a mental health worker after the surgery.”

Before operating and continuing with the surgery, transgender patients have to go through guidelines and be accepted by their psychologist, or a social worker. These guidelines and standards are established by the World Professional Association for Transgender Health (WPATH). This organization is the oldest interdisciplinary professional association in the world concerned with transsexualism.

“Transgender patients have specifically gender identity disorder, but that’s what they’re called,” says Dr. Eisemann, “and the patients are internationally accepted through guidelines. Basically, we don’t do the surgery until the patient qualifies. They have to be either using estrogen or testosterone for at least six months, then treated by an endocrinologist. After that, a letter needs to be obtained from a licensed mental health worker, such as a psychologist or a social worker. Generally, these people have to be at least be living, working in the appropriate sex at least a year.”

Dr. Eisemann has his own practice, Eisemann Plastic Surgery Center, where he performs surgeries for transsexuals.


“The surgeries we perform…let’s say for male to female,” explains Dr. Eisemann. “The facial feminization procedures include nasal surgery, such as a rhinoplasty, or a lowering of the supraorbital ridge, which is the brow, or breast orientation or a chin reduction. We also do a tracheal shave, which is reducing the size of the Adam’s apple.”

Dr. Eisemann continues, “With female to male transgender patients, we basically do the total mastectomy with a free nipple graft. So, we do a number of procedures for the patients. Mastectomies are basically what we do for breast cancer. But they have to have the right criteria and meet certain standards.”

Dr. Eisemann has been doing these kinds of surgeries for more than 10 years and each procedure takes a certain amount of time, he says, depending on the type of surgeries. Some procedures can take hours, with some taking up to three hours or more. The cost depends on the surgery.

“It would be the same cost for a patient who is not transgender,” Dr. Eisemann says. “Plastic surgery can range from several thousands of dollars to $10,000 or $20,000. It just depends on the surgery and how many surgeries are done. Two or three surgeries can be done at a time, especially in the face if you’re doing nasal, forehead, or neck surgery.”

Dr. Eisemann says even though he operates on many transgender patients, he doesn’t really know if it’s because more transgender people are starting to become more open about them.

“I have witnessed doing a lot of these surgeries, but that’s just a function of what I do,” Eisemann explains. “It doesn’t necessarily mean there is an increase of patients, or it doesn’t mean there is an increase of surgeries being done. The patients do come into my office for a referral, and I certainly do see many patients. There are even some cases where insurance will even cover the procedures. It’s happened in the past, so that may encourage more people to have it done, or otherwise they wouldn’t because of the cost.”

According to Dr. Eisemann, he believes doctors who do transsexual surgeries are becoming more accepting of transgenders.

“To my expense, the patients have been very grateful, and appreciative,” explains Eisemann. “I think doctors are being more accepting to the surgery. Transsexuals are being identified now as a pathological disorder. I think it’s more recognized as a gender identity problem. So having these surgeries done to them certainly helps a great deal.”

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