Gender reassignment surgery is a major life goal for many Americans. Sometimes called gender confirmation surgery, it can be seen as the end-goal of a long, personal journey.

These terms refer to surgical solutions that an individual may pursue to affirm their gender. They may also treat gender dysphoria—a form of mental distress that can arise from a mismatch between an individual’s gender and the one that they were assigned at birth.

If you’re considering this process, you’ll have a lot of questions about how gender reassignment surgery works, starting with who undergoes the process, and why some may choose not to.

How Many People Seek out Gender Reassignment Surgery?

The Williams Institute at the UCLA School of Law estimates there are around transgender 1.4 million adults in the United States.

But not all those individuals seek out gender confirmation surgery. Reasons for why this is the case vary.

Expense is certainly a factor. Many insurers are reluctant to cover the procedure, and even Medicare barred the procedure until 2014.

Others don’t pursue surgery because they’re satisfied with hormone replacement therapy (HRT). HRT introduces increased levels of either estrogen or testosterone into the patient. It’s usually the first step before surgery is ever considered.

How Gender Reassignment Surgery Works

The process can be broken down into two major sets of surgeries, colloquially called “top surgery” and “bottom surgery.” They’re so-named in reference to the areas of the body the surgery concerns, either the chest or pelvic regions.

Top surgery—or transgender breast surgery, as it could be called—is the less substantial of the two procedures. It’s usually the first of the two a patient will undergo.

Transwomen, for instance, often experience some degree of breast growth while undergoing HRT. But everyone responds to therapy differently. Some will opt for top surgery—usually entails a breast augmentation—as a part of their process.

For trans men, the process is effectively the opposite. HRT may cause breast-loss, but rarely to the extent that patients require. So in these cases, top surgery will call for a double-mastectomy.

Bottom surgery is a more complex process, and the course taken depends on the goals of an individual patient. Male to female surgery entails vaginoplasty, the process of creating a vaginal canal, and often a labia and vulva as well.

Female to male surgery is less often attempted due to a lower rate of success. Different approaches may involve attempting to construct a working penis out of the clitoris—first enlarged using hormones—or by using tissue graft sources from elsewhere in the body.

In either case, prospective patients need to seek out a consultation with a trusted specialist before deciding on how to proceed.

Gender Confirmation Surgery Is a Personal Matter

Like any major medical procedure, gender reassignment surgery should be carefully considered. And for those dealing with gender dysphoria or other conditions, it should not be viewed as a miracle cure.

But it can be an affirming experience for many. And anecdotal accounts suggest cases of patients regretting the procedure are vanishingly few.

While you contemplate your decision, though, it is of course to feel your best. And for many, looking their best is a big part of that. For all of the style and beauty tips and tricks that you need to do both, be sure to keep up with all of the latest from  FashionWindows.