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One important consideration is that any trans man who develops vaginal bleeding after successfully ceasing menses on testosterone, must be evaluated by a gynecologist. Her work can be found at http: Completely removing and grafting often results in a loss of sensation of that area that may take months to over a year to return, or may never return at all; and in rare cases in the complete loss of this tissue. Many trans men considering the option do not opt for genital reassignment surgery [ citation needed ] ; more frequent surgical options include bilateral mastectomy removal of the breasts and chest contouring providing a more typically male chest shape , and hysterectomy the removal of internal sex organs. Sex reassignment surgery is usually preceded by beginning hormone treatment with testosterone. By some doctors, the surgery is done in two steps, first the contents of the breast are removed through either a cut inside the areola or around it, and then let the skin retract for about a year, where in a second surgery the excess skin is removed. Articles needing additional references from August All articles needing additional references Articles needing additional references from May Articles lacking reliable references from June All articles lacking reliable references Articles with multiple maintenance issues All articles with unsourced statements Articles with unsourced statements from October Articles with unsourced statements from February Articles that may contain original research from June
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