Gender Affirming Surgeries Toby R Meltzer, MD Scottsdale, Arizona Biography !  BS Louisiana State University Baton Rouge !  MD Louisiana State University Medical School !  General Surgery Residency, Charity Hospital of New Orleans !  Plastic and Reconstructive Surgery, University of Michigan Medical School !  Fellowship in Burn Surgery, Wayne State University !  Board Certification in Plastic Surgery and General Surgery !  Assistant Professor of Surgery, Oregon Health Sciences University (1990-1996) !  Chief of Plastic Surgery at Veterans Administration Hospital of Portland (1990-1995) !  President, Oregon Society of Plastic Surgeons (1995-1997) !  Private Practice, Eastmoreland Hospital Portland Oregon 1996-2003 !  Private Practice, Honor Health 2003-Present Pre-operative Requirements !  World Professional Association of Transgender Health (WPATH) !  Psychotherapy !  Hormone Therapy !  Real Life Experience Hospitalization !  Why? !  Why not? !  Major surgery with life !  Reduced costs? threatening risks !  Self-insured !  Regular after-care !  Insurers !  Rapid treatment of !  Hospital acquired complications complications Hospitalization !  Why? !  Why not? !  Major surgery with life !  Reduced costs? threatening risks !  Self-insured !  Regular after-care !  Insurers !  Rapid treatment of !  Hospital acquired complications complications Greenbaum Surgical Specialty Hospital Honor Health System GENDER CONFIRMING SURGERY FOR TRANS FEMALES Modern Vaginoplasty Technique !  Penile Inversion !  Clitoroplasty !  Sensate Flap from Glans of Penis Modern Penile Inversion Vaginoplasty !  Penile Skin Vaginal Lining !  Scrotum Labia Minora/Major !  Glans Penis Clitoris Embryologic Equivalents