The SOC are based on the best available science and expert professional consensus. The SOC pose emphasis on the close working relationships with other health professionals who have been actively involved in the clinical care of the patients, such as surgeons, mental health professional sand if applicable the physician who prescribes hormones [ 17 ]. To date, it rarely happens that a single clinic is able to offer all these techniques, and that all the surgical refinements recently described would be incorporated in the chosen penile reconstruction technique. Usually 12 months of continuous hormonal therapy for those without a medical contraindication 12 months of successful continuous full-time real-life experience Regular participation in psychotherapy, if required by the mental health professional Knowledge of cost, lengths of hospitalizations, likely complications, postsurgical rehabilitation requirements Awareness of different competent surgeons. Part of a series on. Nevertheless, the SOC are very clear about too large amount of information that the patient should receive including advantages and disadvantages of each technique with limitations to achieve ideal results, full range of before-and-after photographs of surgeon's own patients including both successful and unsuccessful outcomes, and surgeon's own complication rates with each procedureand the possibility for the surgeon to refer the transsexual person to a colleague performing a different technique.
Health economic studies in this field are needed. It is not known if this group received sex reassignment surgery outside Sweden or has not received, or did not want surgery at all. In some countries or areas, local standards of care exist, such as in the Netherlands, Germany or Italy. Common treatments include cross-sex hormone therapy; genital reassignment surgery; nongenital surgical procedures of the face, breast, or body; speech and voice therapy; and facial hair removal.
Furthermore, metoidioplasty results in a micropenis, without the capacity for standing urination or sexual intercourse [ 1822 ].