In according to increasing of trans gender patients in all around of the world and the social and sexual problems sex assignment surgeries are discovered to help the patient to have their normal life without a problem. In this article, we try to show all process of sex assignment treatment and surgeries process. Transsexualism can happen because of different reasons maybe from the birth time or after in childhood time. In some cases, parents try to make him as a girl or him as a girl with wearing against dress and hairstyles and etc. Some reasons can be the pressure in the society to accept them as an opposite gender. In according to previous studies transsexualism is a perforation. But parents have the most important role in children life and they should be more careful about their behavior as a first small society for each person. On the whole, there are 2 kinds of MTF transsexual: 1. Homosexual MTF 2. Autogynephilic transsexuals who want to change to female.These patients always say “ I had always a feminine sense in my life, I liked always pink colors, I had always like a woman feeling and desire”. These sent access how that they are a woman in their brain and live with the ambition of being as a complete woman physically. Unfortunately, society doesn’t have good behavior with these people and they try to live widely far from the others. As increasing of MTF patients and don’t have a good position in the society and want to be as their request gender, transsexual surgeries are so important to help them live as their own real wanting gender. Transsexual word is using for the people who their behaviors are not in collaborate with their birth sex. Gender reassignment is surgeries combination (genital and nongenital surgeries) which can cure transgender patients. MTF (male to female) transgenders are those people that born as a female and have female behaviors. The surgeries for MTF transsexual patients are Breast implants, clitoroplasty, labioplasty, orchidectomy, penectomy and vaginoplasty. In this article, we try to explain who are the MTF people and how will be done their surgery. On the second half of twenty-century medical technology was developed for sexual reassignment surgery (Susan Stryker, 1994). For making sure about patient’s surgical readiness universally is recommended to get permission from Standards of Care (SOC) of the WPATH(World Professional Association of Transgender Health)which is around 1 year after hormone usage. For being ready for surgeries is advised to stop all hormonal therapy for 2-3 weeks. Totally in transgender surgery participate, psychiatrists, psychologists, plastic surgeons, urologists, plastic surgeons, and gynecologists. The first step to treatment MTF is hormone usage and the goal of this treatment is a reduction of secondary sexual characteristics hormones or genitalia of the core gender. The Standard of this treatment is established by SOC . Sometimes there is some problem for hormone usage by transgender people to use nonmedical hormones and noncontrol usage so it is important to be under psychiatric control and use dosage in according to the SOC standards because nonmedical hormone usage can have side effects and be harmful to health. For MTF gender reassignment after topping hormone therapy, start FFS, breast implants and following genital surgeries which consist of orchidectomy, clitoroplasty, labioplasty, penectomy and vaginoplasty. Orchidectomy: This part will be done by a urologist. For making deep inguinal ring will resect ductus deferens and testicular vessels which are spermatic cord. FFS: Is one group of surgeries which help to feminize the face and most use for transgender people. It consists of hairline correction, forehead contouring, brow lift, rhinoplasty, cheek implants, buccal fat, lip augmentation, and taper, genioplasty, and thyroid and trachea shave Breast implant: During this surgery will put silicone implants in different size according to body shape and make bigger breasts. Clitoroplasty: Since 1988 to present the dorsal place of glans penis with dorsal neurovascular pediculus is using for clitoroplasty and all patients are satisfied and no problem in urinate system. Penectomy: Urethral catheter will insert into the urethra and corporacarvenosa will form from the down part of spongiosum corpus to the penis crust. After that, the corporacarvenosa will be shaped to the crust. Vaginoplasty: The urologist will transect central tendon and will divide transversely recto urethral is and levator ani muscles. Then Denon Villiers’ fascia will expand and a vagina cavity will create at the middle of there ctumand Denonvilliers’ fascia. Labiaplasty: With suturing of both sides of scrotum which is pulled down will make labia major and with there remaining part of the penis will make labia minor. Also, there are some other surgeries like voice surgery, and other masculinization and feminization procedures . On the whole, for transgender people, the transition time is very important for their health and personal safety, psychological well-being, and self-confident. With doing these surgeries they will sense more feminization in front of the other sand be more confident to come out and can have their normal life same as the others. They can have a normal social life, normal sexual life and can get an orgasm. Finally, it is one preferation and we should respect their living style choice.