Transgender people (TRANS) are mentally and biologically healthy. Aggression, marginalization, lack of opportunities, social invisibility, favor their Gender Dysphoria and suicide even more. There is inconsistency between their gender identity, their biology, civil name, and the social expression of gender that is expected by their environment. The feminine Trans has a feminine gender identity, biology and masculine civil sex, being required in the social to express the masculine role. The masculine Trans identifies as male even though his civil and biological sex is female. Law and Medicine, overcoming unfortunate and inhuman historical conduct, have promoted civil sex change laws. Medicine supports psychologically and offers Body Readjustment or Gender Reaffirmation Therapy. Understands: 1.- Hormonal therapy that tries to make identity and biology congruent by modifying the phenotype and hormonal levels; 2.- The Surgery performs breast, aesthetic, internal genital or external genital plasty procedures, according to the Trans person and respecting international protocols. The Anesthesiologist must: 1.- Together with the entire surgical team, grant due humane treatment as indicated in the publication; 2.- Develop a special, respectful treatment with the Trans person, which includes grammatical changes in the conversation (social name, articles, pronouns); 3.- Preoperatively, the Anesthesiologist must be aware of the hormonal therapies in progress; avoid problems of morbidity and even lethality induced by hormonal effect (thromboembolic disease). Monitor hepatic, metabolic, vascular, electrolyte and hematological changes more rigorously than in the non-Trans patient.