Sex Reassignment Surgery (initialized as SRS; also known as Gender Reassignment Surgery, Gender Affirmation Surgery (GAS), Sex Re-alignment Surgery or Sex-change operation) is a term for the surgical procedures by which a person’s physical appearance and function of their existing sexual characteristics are altered to resemble that of the other sex. It is part of a treatment for gender identity disorder or now better termed as Gender Dysphoria in transsexual and transgender people. It may also be performed on intersex people, often in infancy.
People who pursue sex reassignment surgery are usually referred to as transsexual; “trans” – across, through, change; “sexual” – pertaining to the sexual characteristics (not sexual actions) of a person. More recently, people pursuing SRS often identify as transgender instead of transsexual.

“It must be very clear that the outcome of any SRS reconstructive surgery is completely irreversible, can never be as realistic as natural ones, and after SRS, one can never become a genetic father or mother for whole life.”
Requirements for Sex Reassignment Procedures
The minimum requirement to start Hormonal therapy or Breast Surgery is:
- Patient must be a major (or Parental release form).
- Must be in stable frame of mind, and are living in society as the new desired external appearance (Real Life Experience) for at least 3-months.
- Consultation & counselling with psychiatrist (mental health physician) for at least 3-months, to rule out any abnormal mental status or infatuation or temporary attraction/any secondary gain; and approval of psychiatrist to undergo hormonal therapy and/or breast surgery.
- Affidavit (notarized) from patient that he/she is major and can fully understand pros/cons & take the decision regarding the therapy/surgery.
The minimum requirement for Genital Surgery is:
- Patient must be a major (or Parental Release Form)
- If married, the spouse must sign Spousal Release Form
- Must be in stable frame of mind, and are living in society as the new desired external appearance (Real Life Experience) for at least 1-year.
- Continuous consultation & counselling with psychiatrist (mental health physician) for at least 1-year; and approval with two independent Psychiatrists for surgery at two different intervals (a gap of at least 6-months) to rule out any abnormal mental status or infatuation or temporary attraction and IQ of patient.
- Affidavit (notarized) from patient that he/she is a major and can take decisions regarding the surgery after fully understanding the pros & cons and understanding of irreversibility of the procedures.
Male to Female or M to F (Trans Female)
The procedures involved systematic excision of penis & testicles, Creation of neo-vagina using penis skin, creation of labia majora & labia minora by scrotal skin and creation of clitoris by de-bulked sensate flap of glans penis. Breast implant (Silicone cohesive gel or expander implant) completes the procedure. Though the surgery can be performed in single or two stages, but few further stages may be required to fine-tune the result or to perform ancillary procedures like laser hair removal, vocal cord surgery to change the voice etc.
The postoperative outcome of vaginoplasty is variable. It usually allows coitus (sexual intercourse), although sensation might not always be present. The physical factors, the narrowness of the male pelvis can reduce the available area to use for vaginoplasty and limit vaginal dimensions.
Female to Male or F to M (Trans Male)
F to M is more complex and complicated procedure than M to F. The surgery is always staged and are :
- Excision of breast, salpingo-oophorectomy, hysterectomy & excision of vagina (in Single or two stage, depending on completion of formalities)
- Reconstruction of neo penis using microsurgical technique.
- Placement of penile implants for penile erection.
A gap of 4-6 month is required in between each stage for proper healing of the areas. few further stages may be required to fine tune the results or to perform ancillary procedures like vocal cord surgery to change the voice etc.
Patient Testimonials
Hi All! My name is Angela, and I would love to share my experience while I was at Lucknow! I had come down to India from Bangkok sometime in April 2014, for getting my Sex Reassignment Surgery (Male to Female). I had decided to get my surgery done in India and I came across SIPS online, and immediately felt an unexplained connection. I was so excited and had been communicating to DR. R.K. Mishra through EMails and I felt so very comfortable already! However, once I reached, I was a bit scared about how it will all go, but, after an appointment with him, I was convinced that it will be a smooth process, and that I was lucky to have such an understanding and patient doctor! I felt very relaxed on the day of my surgery, and I woke up in the recovery room, post surgery.The care and hospitality I’d be given, while at the hospital was absolutely wonderful, and I would recommend SIPS to anybody who seeks any kind of cosmetic surgery/treatment. Although it is now almost 2 Months Post Op, I still consult Dr. Mishra and he is as helpful as always! I’d like to thank Dr. R.K. Mishra and his team for the services provided. I recommend SIPS and especially Dr. R.K. Mishra to everybody, and I’m sure the world will be a healthier, better place to live in. **** Good Wishes to Dr. R.K. Mishra and his Team at SIPS.