Programs that are staffed by specialists who provide diagnostic services for people who identify as transgender and offer gender reassignment surgery for those who wish to pursue this option as part of their transition. The procedure usually involves extensive psychological, psychiatric and medical examinations to rule out secondary diagnoses and ensure that the individuals understand the risks of surgery; hormone therapy and surgery to create the appropriate anatomical structures for the new gender; and counseling and support services to ensure that the individuals adjust physically and emotionally to their new bodies.