How Gender Affirmation Surgery Improves Mental Health: Emily’s Story

Emily Tressa shares how gender affirmation surgery improved her life.

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“Before I was able to come out and transition, I was really angry and scared of what people would think about me,” says Emily Tressa, who had gender affirmation surgery just before her 18th birthday. “I was just so uncomfortable, and I remember I would look at myself in the mirror and be like, 'Is it okay that I feel like this? Am I alone?’”

Tressa’s words reflect a mental health issue known as gender dysphoria. In other words, she was having serious distress from the feeling that her assigned gender at birth did not match who she was on the inside. Gender dysphoria can be severe and disrupt a person’s way of life. It even increases the risk of suicidal ideation. (Learn more about gender dysphoria here.)

To Tressa, the solution was clear: She would transition and pursue gender affirmation surgery.

What Does It Mean to Transition?

There are many ways for people to cope with gender dysphoria. It may involve transitioning, which may or may not include gender affirmation surgery. However, not every transgender or nonbinary person seeks surgery. Transitioning may include any or all of the following:

  • Changing your pronouns (for example, from he/him to she/her or they/them)
  • Changing your name
  • Experimenting with different clothing or makeup
  • Trying new hair cuts and styles
  • “Binding” the breasts or “tucking” the penis
  • Getting gender affirmation surgery

However someone chooses to transition, it’s about finding ways to feel more like your authentic self.

What Is Gender Affirmation Surgery?

Gender affirmation surgery is a procedure that changes the physical sex characteristics in order to align with someone’s gender identity. This surgery is also sometimes called gender confirmation or gender reassignment surgery.

People often refer to gender affirmation surgery as a single procedure, but it’s actually a category of surgeries. You may hear people refer to “top surgery” (to add or remove the breasts) and “bottom surgery” (to change a penis to a vulva or vice versa). Another common surgery is a tracheal shave. This reduces the size of the Adam’s apple for male-to-female transitioning.

“Patients pursue gender affirmation surgery for a variety of reasons, and there are as many different reasons for surgery as there are different types of people,” says Jess Ting, MD, Director of Surgery at Mount Sinai Center for Transgender Medicine and Surgery. Dr. Ting performed Tressa’s surgery and helped her in her preparation and recovery.

How Transitioning Can Help Mental Health

Tressa received her gender affirmation surgery in June 2019 during the summer before her senior year of high school. “I had a lot of time to prepare mentally for this surgery, so by the time it finally came, I was ready for it [and] wasn't even nervous,” she says. "I was just so excited and focused and happy that this moment in my life was about to happen.”

As with any major surgery, gender affirmation surgery can require a long and difficult recovery. Still, Tressa says it was “so worth it.” She says, “I am as happy as I can be. … I don't have to worry about tucking or anything like that. I can wear the clothes that I want and be comfortable in my body."

Dr. Ting often asks his patients how they feel after they've recovered from surgery and how it has changed their life. People often tell him that they’ve always felt like this aspect of their body never really fit, and the surgery helped their bodies be a better representation of their authentic selves.

Tressa agrees with that feeling. The gender dysphoria she experienced before has disappeared. “I felt so happy, and I could look at myself in the mirror and be content with what I saw.”