ABSTRACT
Transgender people experience a sense of incongruity between the gender they identify as and the sex appearance at birth, which is independent of their sexual orientation and sexual attraction. Gender incongruence (GI), previously known as gender dysphoria, is a persisting incongruence between an individual's identified and assigned gender, with a desire so strong to be the opposite gender that it causes clinically significant distress or impaired functioning. Gender affirming surgery, which includes any surgery performed to alter primary or secondary sex characteristics, has seen an increase in 155% in America, with a 289% increase in transmale surgery and 41% increase in transfemale surgery. Hormonal therapy can improve transwomen's GI by obtaining a physical and psychological profile more congruent with their identified female gender. Complications of hormonal and surgery treatment for GI are rare, largely owing to stringent selection criteria, high levels of assessment, support, counselling, and follow-up.
