Welcome to the first podcast of October 2018. This is our month on topics around the theme of Gender Identity, the Gender Spectrum, and Gender Transitions. We have a really packed month - with 5 amazing Monday Mumblings, 5 podcasts, 5 blogs, and 4 nuggets. Make sure you stay tuned in to all of our episodes! In This Episode: Today Monkey and the Professor got to chat with Dr. Raj Purohit. Dr. Raj was born in Rajasthan, India (https://en.wikipedia.org/wiki/Rajasthan) but grew up in the midwest - he is a Michigander at heart. He left Michigan to study history and political theory in college - at Williams. He believes that background certainly informs many of his decisions and things he is very passionate about - he grew up in a family of artists and doctors. In medical school, he took a year off to apprentice with a painter in Rajasthan. He attributes his apprenticeship and painting to have a significant impact on how he views surgery. He came back to the US, finished his medical training at Columbia, went on to UCSF for his internship in surgery and residency in urology. He did a Fellowship in pelvic reconstructive surgery - this is where he developed an interest in cis gendered patients originally - in reconstructing the urethra from trauma and complications, and ultimately shifted his focus to developing the Gender Affirmation Surgery program at Mount Sinai a year ago. Dr. Raj made the decision to go into medicine because of his strong family background in medicine, where many of his family members are also doctors. His wife and sister-in-law are both doctors as well. You could consider medicine to be a family business. Even with that, something sparked within him when he entered the operating room for the first time - it was a sense of belonging and home and passion. He sees the surgical suite as a controlled environment, whereas a surgeon, he is an artist - painting the body and bringing out the beauty from within the canvas. Surgery is where he finds his balance in both art and medicine. We started off with a very high-level overview of what is involved in Gender Reassignment. To begin with, the preferred term is Gender Affirmation - because what is really happening is helping the person become externally what they are already internally - it merely affirms their gender identity. At no point are they really assigning a gender to the patient - that patient is already the gender they are on the path to appearing as. We really love that terminology and phrasing. As Dr. Raj states - the doctors are not assigning or giving the patient a new gender - they are only uncovering what is already there, the gender the person already feels exists. (https://amzn.to/2xOODmq) So - Gender Affirmation Surgery typically involves some level of reconstruction on the body so that the body will fit the gender that the person already identifies as. Patients have already gone through hormonal therapy and have had changes in their bodies to reflect the correct gender profile. These surgeries are broadly split into two groupings - Top Surgery and Bottom Surgery (https://www.plasticsurgery.org/reconstructive-procedures/gender-confirmation-surgeries). For transwomen (assigned male at birth, but identify as female) the surgery may entail: facial feminization to transform the masculine features of the face to a more feminine appearance (https://www.healthline.com/health/transgender/facial-feminization-surgery) vocal chord surgery (https://health.howstuffworks.com/medicine/surgeries-procedures/transgender-voice-surgery.htm) breast augmentation to enhance the size and shape of the breasts to create a more feminine appearance to the chest Creation of a vagina through a surgery called vaginoplasty https://www.plasticsurgery.org/cosmetic-procedures/vaginal-rejuvenation/vaginoplasty This typically includes removal of the testes as well For transmen (assigned female at birth but identify as a male) the surgery may entail: