Since 2018, the number of sexual reassignments has been steadily increasing in Switzerland. In 2023, 556 people had recourse to such an intervention – 70 more than in 2022, notes the “NZZ am Sonntag”. What is particularly striking is that twice as many women (385) as men (171) have changed sex. Specialist doctors and those affected can only speculate as to the cause of this development, given the complexity of the subject.
An important reason could be medical, knowing that by far the most common operation is mastectomy. In 2023, 267 people assigned female at birth had their breasts removed in Switzerland, while only 20 people assigned male opted for breast construction. Other sex reassignment interventions were significantly less frequent: 24 phalloplasties (creation of penises) and 79 orchiectomies (removal of testicles).
Breasts can only be removed surgically and can be built up using hormones, recalls Dr. David Garcia Nuñez, director of the Innovation Focus on Gender Variance at University Hospital Basel. “Trans men who no longer want to have breasts must therefore have surgery in all cases. Which is not necessarily the case for trans women who want to have breasts,” he notes.
In addition, mastectomy, offered by many hospitals and for a long time in Switzerland, also to women suffering from breast cancer, has proven itself. And it is less risky than operations on the genital area. This could contribute to its being particularly requested during sexual reassignments.
In addition, men generally change their sex much later than women: on average, the former were 34 years old at the time of the operation, the latter 27 years old. And among those assigned to the female gender, some were under the age of 18. In 2023, 32 minor women underwent mastectomy. This is also more than in previous years.
More non-binary people
A second reason explaining the majority of women having changed their sex could be linked to the increase in the number of non-binary people – who feel neither female nor male – including a much larger number of women. They are increasingly having breasts removed which they consider to be embarrassing, notes Dr Garcia Nuñez. Finally, the lower number of men who change sex could be linked to the stigmatization of the latter. Because trans women are often the subject of strong discrimination and hostility. Wearing a skirt or wearing makeup can already arouse hostility in the street and thus discourage those affected from undergoing interventions.
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