The permanent change of the male into that of a female is known as a sex change male to female. This type of sex reassignment surgery includes a change in the appearance of the genitalia and in some cases the function of the genitalia. Before sex change surgery from male to female is considered the patient must undergo intensive therapy, certain medical procedures, and meet prior conditions. Psychotherapy is required by most sex change surgeons before any operations are performed. The patient's doctor may require him to live as a woman for one year before making the permanent decision to become a woman. Transwomen can also complete medical therapies such as hormone replacement therapy. Once the female to male sex change surgery is complete the patient may choose to partake of treatments such as laser hair removal and voice training to make the transformation complete. Additional surgeries are also offered such as one that feminizes the facial features.