Johns Hopkins University, which in the s was one of the first medical institutions to perform sex reassignment surgery, halted the practice when officials concluded that it was not helping the transgendered overall. They also can have their Adam's apple shaved down so it is less prominent. Do many people regret having the surgery? Fred Ettner, a physician in Evanston, Ill. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group. That is usually followed by a period of living publicly as a member of the opposite sex and, finally, surgery to alter the genitalia and other body parts. A 2o11 study of Swedish transsexuals by the Karolinska Institute showed that "after sex reassignment, [they] have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. But that doesn't mean that surgery is a miracle cure for the difficulties of gender dysphoria. And if there were, there is no agreement on what "trangender" means. Last year, Medicare lifted a year ban on coverage for gender reassignment surgery , and the surgery was performed on year-old Army veteran. Spiegel discusses the tracheal shave cosmetic surgery procedure to reduce the size of an Adam's apple. Bowers said that only two of the 1, people she has operated on have wanted to go back to their old bodies. Marci Bowers, a transgender obstetrician and gynecologist in Burlingame, Calif.