The reason gender reassignment surgery is possible is because all human beings begin life with the same anatomy, with the ovaries starting from the gonadal ridge, becoming testicles if they drop and remaining as ovaries if they do not. In addition to this, the clitoris is effectively a short penis as both genitalia are physically and anatomically identical (e.g. nerve ending bundles, interior connection and placement, sexual function etc.). When male anatomy is transitioned into female anatomy, a reversal of embryology occurs. When a biological male transitions to become female, during surgery, the scrotal skin is excised after which it is opened to form the labia majora and labia minora, and part of it is utilized to line the new vaginal cavity. The testicles are removed in their entirety and the cliterous is formed using the head of the penis which allows the cliterous to function as it does upon the body of a biological female, with most patients able to orgasm post surgery once healed. The volume of erectile tissue is decreased as the penis is effectively folded over, but because the nerves and arteries remain attached, sensation remains. Once the cliterous is sutured into place, the vaginal tunnel is created which is the most difficult aspect of the entire surgical procedure. A space is created between the bladder and the rectum which is difficult as both structures contain significant blood supply and injury to these systems can cause major complications. A skin graft from the scrotum is then set in place onto a cylindrical mold and sutured around it once the cavity is produced so that it can be implanted. Hair follicles are obliterated as they will continue to grow internally if not removed which would cause further complications. The mold used is an approximation of the average male penis which allows surgeons to create a cavity large enough to allow for sexual intercourse if desired. Small cosmetic details are taken care of after which the patient is sutured and migrated out of the operating theater so that they can be left to rest and reawaken after the anesthesia administered wears off

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