It has been 44 years since the first demonstration in Barcelona in support of gay rights. Over these four decades, the social situation of the LGTBI+ community has changed drastically. However, the recent homophobic and transphobic attacks remind us that there is still much work to be done.
Dr Ivan Mañero, Director of the IM GENDER Unit and specialist in genital affirmation surgery, has witnessed many of these changes first-hand, particularly regarding transgender people. “When I began more than 20 years ago, genital surgery for transgender individuals wasn’t even mentioned at medical conferences.
In fact, because I specialised in genital affirmation surgery, I wasn’t invited to certain congresses. As society began to offer greater visibility and social acceptance to trans people, the medical community also evolved. Today, this topic receives more attention in international multidisciplinary meetings and medical specialty conferences. Gradually, we are even seeing dedicated events on gender-affirming surgery and related medical approaches,” explains the internationally recognised plastic surgeon who has performed over 2.400 gender-affirming surgeries.
Working Alongside Medical Professionals
This initial lack of understanding from both society and the medical field prompted him to work in two directions: offering care to trans individuals as the main goal, while also educating and raising awareness among healthcare professionals about a reality that was largely unfamiliar to them.
“As society has enabled greater visibility for trans people, the medical community has also changed,” says Dr Mañero.
In addition to participating in conferences, publishing scientific and educational articles, and engaging with media to increase visibility for the trans community, Dr Mañero aimed to make IM CLINIC (home to the IM GENDER Unit) a teaching centre for plastic surgery residents. For over five years, this goal has been a reality.
“In our unit, we aim to train professionals with a global perspective, not just a surgical one. Of course, having excellent technique is essential – this is a highly complex surgery that demands great anatomical knowledge and surgical skills. But we also focus on social and human aspects, so our trainees develop empathy for trans patients. They need to understand their context, life experiences, expectations, fears, and decisions. It’s crucial not only to know how to operate, but to truly understand each patient and offer them what they genuinely need,” he explains.
In this regard, IM GENDER is currently developing an international master’s programme: “POSTGRADUATE MASTER’S Programme in Gender Confirmation Surgery”, which is set to become a global reference in transgender health and surgical training.
Over 20 Years Supporting Trans People
The IM GENDER Unit at IM CLINIC opened its doors in 1999 under the leadership and deep personal involvement of Dr Ivan Mañero. Over the last 22 years, IM GENDER has become a global reference in Genital Affirmation Surgery and the multidisciplinary care of trans people.
A pioneer in several gender-affirming techniques, Dr Mañero has worked with various public administrations to ensure that these surgeries are included within national public healthcare services. He also contributed to the creation of units such as the Gender Identity Unit at Barnaclínic, and the Surgical Gender Unit in Cuba, where he travelled to establish protocols, perform surgeries, and train healthcare professionals in the field of genital affirmation surgery.
Over these two decades, what matters most to Dr Mañero is “being able to accompany trans people on their journey and do our part to promote normalisation and inclusion in a diverse and respectful society.”
A Long Journey for IM GENDER
This philosophy defines IM GENDER at IM CLINIC and shines through in the words of patients like Eva, who underwent vaginoplasty: “What I take from IM CLINIC is the kindness of everyone. From the moment I walked in and was welcomed by the receptionist, I knew I wanted to have surgery there. The delicacy of everyone, the sweet support of the patient care team, the warmth of the nurses, the doctors… It was a week where I truly felt cared for. And the result, fantastic.”
Álex, a young phalloplasty patient, had a similar experience: “Choosing to undergo phalloplasty is not easy. The surgery and recovery are challenging. But when you know you’re in the best hands, with the best team, and then you see the results, I would absolutely do it again and choose IM GENDER.”
IM GENDER’s work has also received support from public figures such as Amor Romero, actress Abril Zamora, Miss Ángela Ponce, and Italian actress Vittoria Schisano. Vittoria, a patient of Dr Ivan Mañero and IM GENDER, openly shares: “Dr Mañero supported me from beginning to end, with incredible sensitivity. Thanks to him and IM GENDER, I have become the person I always was. I finally recognize myself.”