Gender affirmation surgery refers to procedures that help people transition to their self-identified gender. Gender-affirming options may include facial surgery, top surgery, or bottom surgery. Most people who choose gender affirmation surgeries report improved mental health and quality of life because their physical body matches their gender identity. However, people who choose gender affirmation surgery do so because they experience gender dysphoria, the distress that occurs when one’s sex assigned at birth does not match their gender identity. The term transgender describes someone whose gender identity is different from the sex assigned at birth. Gender nonbinary describes someone whose gender identity does not fit within traditional female or male categories. Such people may opt for gender affirmation medical treatment or surgery that gives transgender people a body that aligns with their gender. It may involve procedures on the face, chest, or genitalia. Standard transgender surgery options include facial reconstructive surgery to make facial features more masculine or feminine; chest or “Top” surgery to remove breast tissue for a more masculine appearance, or enhance breast size and shape for a more feminine appearance; and genital or “Bottom” surgery to transform and reconstruct the genitalia. Surgery is just one option.
Unfortunately, not everyone who is transgender or nonbinary chooses to have surgery. Depending on one’s age and preferences, one may choose hormone therapy to increase masculine or feminine characteristics, such as body hair or vocal tone; puberty blockers to prevent puberty from happening; and voice therapy to adjust one’s voice or tone or help with communication skills, such as introducing oneself with their pronouns. People may also socially transition to their true gender with or without surgery. For example, as part of social transitioning, one might adopt a new name, choose different pronouns, and present their gender identity by wearing different clothing or changing their hairstyle. Around 1 in 4 transgender and nonbinary people choose gender affirmation surgery. Before surgery, work with a trusted healthcare provider. A healthcare provider can help one understand the risks and benefits of all surgery options. Many insurance companies require the submission of specific documentation before they cover a gender-affirming surgery. This documentation includes health records showing consistent gender dysphoria and a letter of support from a mental health provider, such as a social worker or psychiatrist.
What happens during surgery varies depending on the procedure. One may choose facial surgery, top surgery, bottom surgery, or a combination of these operations. For example, facial surgery may change one’s cheekbones (for transgender women, injections to enhance the cheekbones), chin (one may opt to soften or more prominently define their chin’s angles), jaw (a surgeon may shave down the jawbone or use fillers to enhance the jaw), or nose (one may have a rhinoplasty, surgery to reshape the nose). A transgender woman (assigned male at birth or AMAB) may have other surgeries, including adam’s apple reduction, placement of breast implants (breast augmentation), removal of the penis and scrotum (penectomy and orchiectomy), and construction of a vagina and labia (feminizing genitoplasty). A transgender man (assigned female at birth or AFAB) may have other surgeries, including breast reduction or mastectomy, removal of the ovaries and uterus (oophorectomy and hysterectomy), and construction of a penis and scrotum (metoidioplasty, phalloplasty, and scrotoplasty). Recovery times vary based on the procedure or combination of procedures: cheek and nose surgery (Swelling lasts for around two to four weeks), chin and jaw surgery (Most swelling fades within two weeks, but swelling may take up to four months to disappear), chest surgery (Swelling and soreness last for one to two weeks, but avoid vigorous activity for at least one month), and bottom surgery. Most people do not resume usual activities until at least six weeks after surgery.
Have weekly follow-ups with the healthcare provider for a few months to ensure that one is healing well. Surgery is only one part of the transitioning process. After surgery, work with a therapist or counselor. This professional supports social transitioning and one’s mental health. The transgender individuals who have chosen gender-affirming surgery have long-term mental health benefits. A person’s odds of needing mental health treatment declined by 8% each year after the gender-affirming procedure. Different procedures carry different risks. For example, individuals with bottom surgery may have changes to their sexual sensation or trouble with bladder emptying. In general, significant complications are rare, as long as an experienced surgeon is performing the procedure. There is a small risk of complications with any surgery, including bleeding, infection, and side effects of anesthesia. However, most people who choose these surgeries experience an improvement in their quality of life. Depending on the procedure, 94% to 100% of people report being satisfied with their surgery results. In general, people who work with a mental health provider before surgery tend to experience more satisfaction with their treatment results. After surgery, see the healthcare provider if there is bleeding for more than a few days after surgery, pain that does not go away after several weeks, or signs of infection, such as a wound that changes color or does not heal.
You understand now why keeping my trans secret is still going. 
. but thank you very much! 