In order to regulate the technical audit and clinical application of sex reassignment surgery, to ensure medical quality and medical safety, the development of this specification. This specification for the technical audit of medical institutions to apply for clinical application of sex reassignment surgery technology for the basis of technical audit, is the minimum requirements for medical institutions and their physicians to carry out sex reassignment surgery.
This specification refers to sex reassignment surgery, refers to the plastic surgery means (tissue transplantation and organ reconstruction) to make the physical sex of patients with sexually transmitted diseases and their psychological gender, that is, the removal of their original sex organs and the reconstruction of the new sex of the body surface sex organs and secondary sexual characteristics.
I. Basic requirements for medical institutions
(A) medical institutions to carry out sex reassignment surgery techniques should be appropriate to their functions and tasks.
(B) Level A general hospital or plastic surgery hospital, with the health administrative department approved the registration of plastic surgery treatment subjects.
(C) the hospital has standardized management, normal operation of the medical, legal, ethics and other experts in the clinical application of sex reassignment surgery technology ethics committee.
(D) plastic surgery.
1. set up plastic surgery more than 10 years +, more than 20 beds, with a strong basis for plastic surgery work.
2. able to independently complete a variety of plastic surgery procedures, including organ reconstruction and tissue transplantation.
3. ward facilities to facilitate the protection of gender reassignment surgery patient privacy and psychological treatment, etc.
(E) there are at least two in-service physicians with the clinical application of sex reassignment surgery technology, there are sex reassignment surgery-related knowledge and skills training and assessment of qualified, and other professional and technical personnel to carry out sex reassignment surgery.
Second, the basic requirements of personnel
(A) the surgery team consists mainly of plastic surgeons, if necessary, other relevant departments can participate in physicians.
(B) the surgeon: obtain the “physician’s practice certificate” of the hospital’s doctors in service, the scope of practice for plastic surgery, with deputy chief physician and above professional and technical qualifications; engaged in plastic surgery clinical work for more than 10 years, including more than 5 years of clinical work experience in sex reassignment surgery, has independently completed more than 10 cases of genital rejuvenation.
(C) the first assistant: plastic surgeons engaged in plastic surgery clinical work for more than 5 years, or other related departments with attending physicians and above professional and technical positions qualified.
Third, the basic requirements of technical management
(A) follow the plastic surgery and related disciplines and technical operation routine.
(B) the order of implementation of sex reassignment surgery: genitalia removal, forming is the main surgery of sex reassignment surgery, any surgery to change the second sex characteristics must be performed after gonadectomy or at the same time as gonadectomy.
(iii) Materials required to be provided by the patient before the surgery and conditions that should be met.
1. Materials that must be submitted by the patient before surgery.
(1) A certificate issued by the local public security department that the patient has no criminal record on file.
(2) A certificate of diagnosis of transsexualism issued by a psychiatrist, along with proof that no other abnormalities in mental status are seen; a test by a psychologist proving that his or her psychological sexual orientation is directed toward the opposite sex and there are no other psychopaths.
(3) A written report of the patient’s own request for surgery and notarization.
(4) Proof that the patient has informed his or her immediate family of the proposed sex reassignment surgery.
The above materials must be included in the medical record.
2. Conditions that must be met by the patient prior to surgery.
(1) The requirement for gender reassignment has lasted at least 5 years without recurrent process.
(2) Received psychological and psychiatric treatment for at least 1 year before surgery and it is ineffective.
(3) Not in marital status.
(4) Aged more than 20 years old and is a person of full civil capacity.
(5) No contraindication to surgery.
(4) Before the implementation of sex reassignment surgery, the patient should be fully informed by the surgeon of the purpose of the surgery, the risks of surgery, follow-up treatment after surgery, precautions, possible complications and preventive measures, the consequences of sex reassignment surgery, and sign an informed consent form.
(E) Hospital management.
1. The hospital and the ethics committee must give their consent before the implementation of sex reassignment surgery, and the procedure can be performed only after approval.
2. After completing the first stage of each case of sex reassignment surgery, the relevant information will be reported to the appropriate health administrative department according to regulations.
3. After gonadectomy, send to pathological examination, and other tissues as appropriate.
4. After the sex reassignment surgery, the hospital will issue the relevant medical certificate for the patient so that the patient can go through the relevant legal procedures.
5. Medical staff should respect the patient’s right to privacy.
(F) medical institutions carrying out sex reassignment surgery should establish a sound system of follow-up visits after sex reassignment surgery, follow-up visits and records in accordance with regulations.
(G) medical institutions and physicians in accordance with the provisions of the regular audit of the clinical application of sex reassignment surgery technology, including case selection, surgical success rate, serious complications, deaths, medical errors occur, post-operative patient management, patient survival quality, follow-up and quality of medical records.