Brazil’s transgender twins are world’s first to change sex, doctors say

RIO DE JANEIRO, BRAZIL – Two 19-year-old twins in Santa Catarina state achieved their dream of changing sex through surgery this week. The procedure is considered unprecedented in the world for having been performed on two identical transgender female twins and almost simultaneously, according to the medical team, who performed the sex reassignment surgery at the Santo Antônio Hospital, in Blumenau.

The sisters were born with the biological male sex, and began hormonal treatment with contraceptives at the age of 15 for the transition. The twins, who chose to remain anonymous, are Brazilian and are also the youngest to change sex in the country, based on the Federal Medicine Council (CFM) 2020 resolution that lowered the legal minimum age for the procedure from 21 to 18.

The twins’ procedures took approximately five hours each. One of them underwent surgery on Wednesday, February 10th, and the other on Thursday, 11th. Both will remain under observation in the hospital for three days, according to the medical team, led by José Martins and Cláudio Eduardo de Souza.

“It was a young transition, because up to 2020, the CFM allowed it only for people over 21. There are no reports of twins undergoing sexual reassignment surgery at the same time in the world,” said Martins.

According to the doctors, it was the patients’ decision to undergo sex reassignment surgery virtually at the same time. They had dreamed of undergoing surgery since they were 10 years old, when they learned about the procedure on the internet. Both underwent psychological counseling before being admitted to the surgical center.

“As they are identical twins and began hormonal treatment at the same time, it would be natural for them to want to undergo surgery,” Martins said. “The patient comes in the day before surgery, but first undergoes therapy with mental health professionals over the course of a year in order for us to have an expert report on their condition as a trans female who rejects their sexual organ.”

Surgery technique

The twins’ surgery is considered both cosmetic and functional, because the end result is visually similar to a vagina, and because they retain their sexual and urinary functions. According to the medical team, literature shows that only 5% of trans females choose this procedure.

Since the gender reassignment procedure on the twins was coordinated by two doctors, while one worked on the inner part of the vagina, the other worked on the outer area.

“We used the penile inversion technique with scrotum grafting. We take the skin from the penis and suture the scrotum skin and insert them into a cavity created in the perineal area,” explained doctor José Martins on the procedure performed on the twins.