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May 2, 2026
Christine Bürg & Marianne Waldenfels
Finding alignment between body and identity is a profound journey for many people. Modern transgender surgery offers new possibilities for physical transformation. Munich-based surgeon Dr. Wolfgang Funk shares insights into this highly sensitive field of medicine
An interview with
Dr. Dr. med. Wolfgang Funk
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Around 500,000 people in Germany experience a disconnect between their body and gender identity. Dr. Wolfgang Funk, a Munich-based plastic surgeon, specializes in transgender procedures. He supports patients in aligning their physical appearance with their identity. In this interview, he discusses high-impact procedures, individual treatment approaches, and future developments in the field.
Are there more trans women – meaning individuals who are male at birth but feel more comfortable in a female body – or more trans men?
A very exciting question. Everyone always thought it was at least fifty-fifty or nearly fifty-fifty. That was once the case. For people who are now over 30, 35, or 40, the distribution is still more half-and-half. In the younger generation – roughly between 15 and 30 – it is already more differentiated.
Trans men, meaning women at birth who want to become men, make up about 35%. Trans women are between about 25 and 30 to 35%, so a little less. And then, of course, we also have the entire block of non-binary people, who are now included. So it becomes highly differentiated – with a certain tendency towards trans masculinity.
What is more complicated – to visually transform a man into a woman or to turn a woman into a man?
This also needs to be seen in a very differentiated way. For trans women – that is, a person born male – adapting identity, especially in the face, is highly complex. The body and genital area are also complex. For trans men, however, surgery often plays a lesser role because hormone therapy, that is, testosterone, already achieves a lot: hair growth, changes in facial features, reduction of subcutaneous fat. Testosterone alone does this. For trans men, the focus is mainly on the removal of the breast.
How long does this transformation take in total?
The entire transition usually takes four to five years. It starts with clarification: Is it really transgender or does the person belong to another group? Then hormone therapy begins, combined with psychotherapy. Only then do surgical measures follow. These take about two years – sometimes only one year if everything is optimally coordinated.
Especially in the face, we have many aesthetic zones: forehead, eyes, nose, mouth, jaw, Adam's apple – these are often up to ten procedures. My credo is: The face, as the strongest expression factor, should ideally be adjusted in one step to facilitate quicker social integration.
What do people usually have done first?
It is initially important that there is absolute certainty. If there is uncertainty, surgeries are postponed. Fundamentally, the patient determines what is most important for them. For some, genital surgery is crucial, especially if there is a strong rejection of their own body.
Others are first bothered by the hairline, nose, or breasts. Medically, one might proceed differently, but often the so-called “Heartbreakers” must be treated first to achieve psychological stabilization.
Are the patients already sure with you?
At 99.9%. They already have one to two years of preparation behind them. Those who take this path do so not only out of conviction but from a deep inner necessity—to be able to exist as a human being at all. We are essentially helpers accompanying them on this path.
How old are the patients?
Many report that they felt uncomfortable as early as four, five, or six years old. This is the case in about 60 to 70% of cases. The feeling often becomes very strong with puberty. Surgical interventions generally begin at about 16 to 18 years of age. Earlier might sometimes make sense from a surgical perspective, but there is a desire to avoid making irreversible decisions too soon.
How do you manage to meet the expectations of your patients?
It is an interplay between two people. You listen, try to empathize, develop empathy. The first conversation is mainly about listening. Some bring pictures—not as an exact template, but as a direction. Then I translate these wishes into the respective face. It is a process of many small steps. The most important point is really: listen, feel, and understand—and translate what is said into a surgical solution.
What role does psychological support play?
A central one. Without a psychological diagnosis, I do nothing. Patients are already receiving care when they come to me. It's always a combination of psychology, hormone therapy, surgery, and social environment. I often include family or friends—they are part of the transition.
Were there situations where you refused an operation?
Yes, repeatedly. Not as a clear no, but more like: “You’re not ready yet.” When I operate, everything has to fit together—the patient's wish, my understanding, and my skills. If I don't feel that, I do nothing.
There are new methods to reduce the waist. What is special about them?
The narrow waist is a classic female feature. There are new procedures where ribs are weakened or partially removed to shape the waist. The patient wears a corset for several months afterward. There are risks, but the experiences so far are very good.
Why did you specialize in transgender operations?
I am a very sensitive, yet pragmatic person and have a complex surgical education. But the decisive factor is the emotional component: I see the influence I have on these people's lives. People who previously could not live find a life worth living. That is unimaginably fulfilling. It is the combination of medical skill and the ability to fulfill the deepest wishes - that is, for me, the epitome of being a doctor.
