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The number worldwide is estimated to be two to five times larger. Developing the habits and mannerisms characteristic of the patient's new gender requires many months or years. To change male genitalia to female genitalia, an incision is made into the scrotum A. This dissonance is so profound that they are willing to be surgically altered. History[ edit ] Lili Elbe was the first known recipient of male-to-female sex reassignment surgery, in Germany in And if there were, there is no agreement on what "trangender" means. Alternatives There is no alternative to surgical reassignment to alter one's external genitalia.
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