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As public visibility and institutional support for the transgender and gender non-conforming population continue to increase, the demand for competent multidisciplinary teams of medical professionals equipped to care for this population is expected to rise\u2014including plastic surgeons, urologists, gynecologists, endocrinologists, and breast surgeons, among others. Genital reconstruction procedures for the male-to-female and female-to-male transgender patient present unique surgical challenges that continue to evolve from their respective origins in the 19th and 20th centuries. A historical review of surgical techniques and standards of care attendant to gender-affirming medicine is presented, with foremost emphasis placed on how techniques for genital reconstruction in particular continue to evolve and advance. In addition, the current status of transition-related health care in the United States, including research gaps and contemporary clinical challenges, is reviewed.<\/jats:p>","DOI":"10.1016\/j.jsxm.2017.06.007","type":"journal-article","created":{"date-parts":[[2017,7,29]],"date-time":"2017-07-29T02:00:14Z","timestamp":1501293614000},"page":"991-1002","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":43,"title":["A Historical Review of Gender-Affirming Medicine: Focus on Genital Reconstruction Surgery"],"prefix":"10.1093","volume":"14","author":[{"given":"Jordan D.","family":"Frey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Poudrier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer 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