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The belief: Everyone gets the same surgery.



The reality: Putting it broadly, for male to female gender reassignment surgery, doctors take a penis and make a vagina, clitoris, and labia out of the male parts, Dr. Ting says. Female to male surgery is more complicated, and requires taking skin from somewhere else on the body (like the forearm or thigh), folding it into a tube and reattaching it to the urethra — and the vagina has to come out, too (vaginectomy). Mastectomies and facial feminization surgery are separate procedures, typically.



"I think that most people would be surprised by how malleable the human body is, especially as compared to gender identity," Alexa says. "You can take a girl and feed her testosterone and lies for years, and she will still know, deep down, that she is a girl... But if you take analogous parts of male or female genitalia — and they are extremely analogous — and rearrange them, the body will adjust to make it work as if it was there to begin with."