Understand body feminization for transgender women – 01/28/2024 – Equilíbrio

Uniting mental and bodily identity is one of the challenges of medicine when it comes to transgender bodies – and the way in which this occurs has been changing. Feminization, which for a long time indicated amateur aesthetic procedures that could pose a risk to life, is becoming increasingly professional. Industrial silicone injections to form breasts and buttocks, for example, are losing ground.

According to José Carlos Martins Junior, plastic surgeon and author of the book “Transgenders: Medical Guidelines for a Safe Transition”, even the term breast implant should be avoided as it does not express the complexity of the intervention.

“We call it feminization of the chest, because breast implants are just one part, it’s not simply implanting breasts in a trans woman. You need to place the implants under the muscles. Often, you need to remove fat from the belly to put it together to stay with the most harmonious contour, operate on the armpit region”, explains Martins.

The average cost of feminization depends on the quantity and complexity of the procedures, but for the chest alone it can cost around R$20,000 in Brazil. With LAD lipo, gluteal grafting or prosthesis and rib remodeling, for example, the cost can rise to R$150,000.

The doctor states that there is no such thing as “total feminization, nor complete feminization.” “It’s actually quite bad for patients to hear this term, it hurts a lot, because it gives the feeling that society is recommending surgery. And the need has to come from it”, he says.

In the case of transgender singer and songwriter Verónica Valenttino, 40, winner of the Shell Theater Award for the musical “Brenda Lee and the Palace of the Princesses”, the process of feminizing her body was a milestone in her life.

Started eight years ago, the procedures had a direct impact on her self-esteem and included breast augmentation, use of hormones and facial harmonization with dermatologist and researcher Bianca Viscomi, pioneer of studies and research on minimally invasive interventions for trans people in Brazil.

“I started with hormones. I was extremely thin and during this period I was able to experience and witness new curves in my body. It made me more beautiful, more self-confident and, obviously, a happier person”, says the artist.

The singer’s chest feminization process is reported in the documentary series “Alta Estima”, shown in 2023 on the E! Entertainment and led by doctors Gabriel Basílio and Alexandre Martins

“It’s a very big achievement, because many of us have already died, have already become deformed by undergoing extremely invasive and dangerous processes,” she says.

“There are still many of us who do not have the financial means, who experience this marginalization of our own bodies, being pushed into prostitution all the time. But we have managed to reach other places, conquer other professions, transform this sad reality.”

LGBTQIA+ activist Keila Simpson, president of Antra (National Association of Transvestites and Transsexuals), points out, however, that even with medical advances, transgender people’s access to these procedures still needs to be facilitated, especially in the SUS (Unified Health System) , since not all states have public medical centers capable of caring for this population.

Survey of Sheet showed that only 8 of the 27 units of the Federation have hospitals that offer sexual reassignment surgeries, which leads transgender men and women to leave their states or travel hundreds of kilometers to undergo the procedure.

“These policies are contained in the transsexualization process, it is not a privilege, as many believe. It is a demand from the trans population who need it, who also pay taxes”, says Simpson.

The activist reinforces that the surgical part is only “half” of the process, which also involves important pre- and post-operative phases – limitations of care at any time, therefore, making access to the service a barrier for the group, she says.

According to Martins Júnior, founder of the Transgender Center Brazil, a reference clinic for surgeries for transgender people in the country, safe feminization demands “body planning”. The patient willing to have breasts implanted must, for example, prepare herself with at least three months of hormone therapy.

“Before that, she probably won’t have a breast bud to place the body breast prosthesis. It takes at least between 12 and 24 months to think about liposuction, gluteal fat grafting, a buttock implant. Body procedures they are complements to hormone therapy”, he explains.

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