Sex affirmation surgery is also known as sex reassignment surgery or a sex change operation. It is a procedure that surgically transforms the appearance of a male's body to that of a female or the appearance of a female's body to that of a male. Even the genitalia are transformed during the process. Sex affirmation surgery is the result of intensive therapy and medical evaluations. In addition, most patients will be required to live as their chosen gender for at least one year before any doctor will consent to the surgery. The typical patient has deep feelings of being 'in the wrong body'. This means the pre-operative sex affirmation surgery patient most likely has a brain disconnect which causes them to feel like a male trapped in a female body or vice versa. Post-operative therapies are also imperative for sex affirmation surgery patients who will benefit from psychological counseling, hormone replacement therapy, and even voice therapy.