[Research Report] The market is estimated to grow from US$ 2,909.23 million in 2022 to US$ 6,266.67 million by 2031; it is estimated to record a CAGR of 10.1% during 2022-2031.

Market Insights and Analyst View:

Sex reassignment surgery also known as gender affirmation surgery refers to the procedure that help people transition to their self-identified gender. Gender-affirming options may include facial surgery, top surgery or bottom surgery. Most people who choose sex reassignment surgeries report improved quality of life and mental health. People may have surgery so that their physical body matches their identity/gender identity. People who choose gender affirmation surgery do so because they experience gender dysphoria. Gender dysphoria is a kind of distress that occurs when sex assigned at birth does not match the original gender identity as they grow old. It can be both mental distress and physical distress. Common surgery options include facial reconstructive surgery that make facial features more masculine or feminine, top or chest surgery (enhancing or reducing breast size), and bottom or genital surgery wherein someone can transform and reconstruct the genitalia.

Growth Drivers and Challenges:

Gender dysphoria is defined as the feeling of discomfort that might occur in people whose gender identity differs from their sex assigned at birth. Transgender and gender-diverse people might experience gender dysphoria at some point in their lives. However, some transgender and gender-diverse people feel at ease with their bodies, with or without medical intervention. A diagnosis for gender dysphoria has been included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a manual published by the American Psychiatric Association. The diagnosis was created to help people with gender dysphoria and also get access to necessary health care and cost-effective treatment. According to the State Medicaid Agencies, in 2021, about 42,000 children and teens across the United States received a diagnosis of gender dysphoria, tripling the number in 2017. At least, 121,882 children aged between 6 to 17 were diagnosed with gender dysphoria from 2017 through 2021. For patients that has been diagnosed with gender dysphoria, they initially start with puberty-blocking medications as a first-class treatment option. These kinds of drugs are known as GnRH agonists that helps in suppressing the release of the sex hormones testosterone and estrogen. The U.S. Food and Drug Administration (FDA) approved the drugs to treat mainly diseases such as prostate cancer, endometriosis, and central precocious puberty, but not specifically gender dysphoria. Though these medicines are used as off-label in gender dysphoria cases, they lack support of clinical trials to establish the efficacy and safety of such treatments. In the recent past, there were at least 4,780 adolescents who started on puberty blockers and had a prior gender dysphoria diagnosis. By suppressing sex hormones, puberty-blocking medications stop the onset of secondary sex characteristics, such as breast development and menstruation in adolescents assigned female at birth. For those assigned male at birth, the drugs stop the development of a deeper voice and inhibits the growth of facial and body hair. They also limit growth of genitalia. Without the use of puberty blockers, such physical changes can cause great distress in many transgender children. These puberty-blocker medications are administered as injections, typically every few months, or through an implant under the skin of the upper arm. After suppressing puberty, a child may go on with hormone treatments to initiate a puberty that aligns with their gender identity. Those for whom the opportunity to block puberty has already been passed or those who declined the option may also pursue hormone therapy. Hormones i.e., testosterone for adolescents assigned female at birth and estrogen for those assigned male promote the development of secondary sex characteristics. Adolescents assigned female at birth who take testosterone may notice that fat is redistributed from the hips and thighs to the abdomen. Arms and legs may appear more muscular in nature. The brow and jawline rows considerably. Body hair may coarsen and thicken. Teens assigned male at birth who take estrogen may notice the hair on their body softens and thins. Fat may be redistributed from the abdomen to the buttocks and thighs. Their testicles may shrink and sex drive diminishes. These hormones are taken in various ways, including injections, pills, patches and gels. Some minors will continue to take hormones for many years till adulthood, or they may stop if they achieve the physical traits they want. The ultimate step in gender-affirming medical treatment is surgery, which is uncommon in patients under age 18. In 2021, over 776 mastectomies were performed in the United States on patients aged between 13 to 17 with a gender dysphoria diagnosis. Such factors have assisted the growth of sex reassignment surgery market in the recent years and is expected to continue a similar trend during the forecast period.

Initiatives taken by government is also one of the factors driving the overall sex reassignment surgery market growth. For instance, in October 2022, the Rajasthan government gave monetary support to transgender people looking for SRS (sex reassignment surgery). The Ashok Gehlot-led-government claims that this mainly aimed to ensure a life of dignity for transgender people and enable them to live in their true personalities. This initiative announced the assistance of up to Rs 2.50 lakh for every sex reassignment surgery to each transgender person who wants to transform into a male or female through the surgical process. The surgery will take place only after psychotherapy, hormone therapy, and medications. In September 2023, the Union Government announced that transgenders will get yearly health insurance of upto INR 5 lakh each under the Ayushman Bharat scheme. The insurance will also cover the sex reassignment surgeries. The National Health Authority, under the Health Ministry, signed a memorandum of understanding on this scheme with the Social Justice Ministry.

High cost is one of the factors restraining the market growth of sex reassignment surgeries. Market participants must differentiate in their service offerings to establish a unique value proposition in the market and strengthen their existing foothold. Also, the side effects associated with sex reassignment surgeries is likely to impact the overall market growth critically.

Strategic Insights

Report Segmentation and Scope:

The “Global Sex Reassignment Surgery Market” is segmented based on surgery type, end user, and geography. Based on surgery, the sex reassignment surgery market is divided into male to female and female to male. Male to female sex reassignment surgery segment is classified into feminizing vaginoplasty, augmentation mammoplasty, facial feminization procedures, and other surgical procedures. Female to male sex reassignment surgery segment is classified into phalloplasty, hysterectomy, and other surgical procedures. Based on end user, the sex reassignment surgery market is segmented into hospitals, specialty clinics, and others. The sex reassignment surgery based on geography is segmented into North America (the US, Canada, and Mexico), Europe (Germany, France, Italy, the UK, Russia, and the Rest of Europe), Asia Pacific (Australia, China, Japan, India, South Korea, and the Rest of Asia Pacific), the Middle East & Africa (South Africa, Saudi Arabia, the UAE, and Rest of the Middle East & Africa), and South & Central America (Brazil, Argentina, and the Rest of South & Central America).

Segmental Analysis:

Based on surgery type, the sex reassignment surgery market is bifurcated into male to female and female to male. Male to female sex reassignment surgery segment is classified into feminizing vaginoplasty, augmentation mammoplasty, facial feminization procedures, and other surgical procedures. Female to male sex reassignment surgery segment is classified into phalloplasty, hysterectomy, and other surgical procedures. The male to female segment held a larger share in 2022 and is expected to continue a similar trend during the forecast period. Feminizing vaginoplasty is the most common performed gender-affirming genital surgery for gender-diverse people with genital gender incongruence. The procedure creates an aesthetic and functional vulva and vaginal canal that enables receptive intercourse, erogenous clitoral sensation and a downward-directed urine stream. Penile inversion vaginoplasty (PIV) is a single surgical procedure involving anatomical component rearrangement of the penis and scrotum that enables many patients to meet these anatomical goals. Other potential options include minimal-depth, peritoneal and intestinal vaginoplasty. Patient quality of life has been shown to improve drastically after vaginoplasty, but complication rates have been reported to be as high as 70%. However, most complications do not alter long-term postoperative clinical outcomes and can be managed without surgical intervention in the acute perioperative phase. According to the PubMed Central, the largest amount of high-volume vaginoplasty centers were reported in North America and Europe. Across 17 western centers including the North America and European Union regions, there is significant consistency in practices across some aspects of vaginoplasty. Differences exist in use of extragenital tissue for vaginal canal/apex creation, creation of the clitoral hood and inner labia minora, elevation of the neoclitoral neurovascular bundle, and perioperative hormone management.

Based on end user, the sex reassignment surgery has been segmented into hospitals, specialty clinics, and others. Hospitals segment captured the largest share in 2022 and is expected to follow a similar trend during the forecast period. However, specialty clinics segment is expected to grow at the highest rate during the forecast period. Gender-transition services and surgeries are becoming more widely available across the United States region, and more insurance companies are adding coverage to help over one million Americans who identify as transgender. The Cleveland Clinic, Boston Medical Center, Oregon Health and Science University in Portland and Mount Sinai Hospital in New York City are among the latest medical centers to provide sex reassignment surgery procedures.

Regional Analysis: 

The regions can be segmented into North America, Europe, Asia Pacific, the Middle East & Africa, and South & Central America, North America sex reassignment surgery market captured the largest share in 2022 and is expected to continue a similar trend during the forecast period followed by Europe. The North America region is segmented into the United States, Canada, and Mexico. The United States region captured the largest share in 2022 and is anticipated to retain its dominance during the forecast period. On the other hand, Canada is expected to witness the highest growth rate during the forecast period. The World Professional Association of Transgender Health (WPATH) has standards of care but there is not a standard for coverage and prerequisites across Canada. All provinces and territories across Canada, for instance, provide health coverage for genital sex re-assignment surgery but most health departments require a psychiatrist to approve and refer for the procedure. Wait times for psychiatrists can be years-long in some communities. Most provinces and territories require documented “gender dysphoria” for gender-affirming treatment, including access to hormones and any type of gender-affirming procedure. The International Classification of Diseases removed gender diversity from its list of psychiatric diagnoses, and it is no longer considered a psychiatric disorder. While most provinces/territories cover sex reassignment surgery, there are only three clinics in which these procedures can be done which includes a private clinic in Montreal, Centre Metropolitain de Chirurgie, a small public clinic that’s part of the Women’s College Hospital in Toronto, and the Gender Surgery Program B.C., a public clinic in B.C. (which only treats B.C. and Yukon residents). Asia Pacific region is expected to witness the highest growth during the forecast period. The prevalence of gender identity disorder is quite high in Japan, with the rates calculated for male-to-female to be 1:25,000 and female-to-male to be 1:12,000. There are very few institutions that routinely carry out sex reassignment surgery in Japan, even though it is mandatory for changing sex on the census register at the present time. Such factors are expected to assist the demand for sex assignment surgery in both developed and developing countries during the forecast period.

Competitive Landscape and Key Companies:

Companies such as Andrew Ives, Boston Childrens Hospital, British United Provident Association Ltd., Chettawut Plastic Surgery Center, CNY Cosmetic & Reconstructive Surgery, Costhetics Pty Ltd., Moein Surgical Arts, Mount Sinai Centre for Transgender Medicine and Surgery (CTMS), Oregon Health and Science University, Penn Medicine, Phuket International Aesthetic Centre (PIAC), Plastic Surgery Group of Rochester, Rumer Cosmetic Surgery, Â Sava Perovic Foundation Surgery, and Swedish Health Services are some of the major companies operating in global sex reassignment surgery market. The companies have utilized strategies such as product launch, product up-gradation, patents, expansion of their product portfolio and area expansion for their organizations' growth. In addition, the companies have invested their efforts to develop products/services and received approvals from regulatory bodies such as the US FDA.

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REGIONAL FRAMEWORK MARKET PLAYERS

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