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Although episodes of gender variance have likely been with us from at least ancient history—as evidenced by biblical references, art history, literature, and mythology—medical and surgical treatment of transgender individuals is a relatively new phenomenon developed over the past century. Much of the early work in transgender medicine and surgery and the assumed birthplace of the modern transgender movement was pre–World War Berlin, Germany. While gender expression as a reflection of historical binary standards of gender (male or female) is increasingly challenged today, surgery, as one component of medical treatment for gender dysphoria (i.e., discomfort with one’s assigned birth gender), is addressed here.

Gender confirmation surgery (GCS) and gender reaffirmation surgery (GRS) are equivalent designations supportive of the notion that gender identity is established biologically, often ...

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