Bottom surgery for female-to-male (FTM) transgender individuals typically refers to procedures that create male-typical genitalia. There are two primary types of bottom surgeries for FTM individuals: metoidioplasty and phalloplasty.

  1. Metoidioplasty: This procedure takes advantage of the clitoral enlargement caused by testosterone hormone therapy. The enlarged clitoris is released from its ligamentous attachments to increase its prominence, simulating a small phallus or penis. Urethral lengthening can be done as well to allow for standing urination.
  2. Phalloplasty: This procedure involves constructing a neophallus (new penis) typically using grafts from the forearm, thigh, or back. It’s a more complex procedure than metoidioplasty and often requires multiple surgeries.

The cost for these surgeries can vary widely based on several factors:

  • Geographic Location: Costs can vary depending on the country or even within regions of a country.
  • Surgeon’s Experience and Reputation: More experienced surgeons or those with a high reputation might charge more.
  • Complexity of Procedure: Costs may vary depending on what specific procedures are being done. For instance, whether or not urethral lengthening, vaginectomy (removal of vaginal tissue), or scrotoplasty (creation of a scrotum) is performed can influence the price.
  • Medical Facilities: Whether the surgery is performed in a hospital versus an outpatient surgical center can influence the cost.
  • Additional Costs: Pre-operative assessments, anesthesia, post-operative care, hospital stay, and potential future revisions or additional surgeries can add to the cost.

As of my last update in 2021:

  • Metoidioplasty typically costs anywhere from $7,000 to $20,000 USD or more.
  • Phalloplasty is generally more expensive, with costs ranging from $50,000 to $150,000 USD or more.

Note that these are approximate ranges, and actual costs can vary. Some health insurance plans in certain countries or regions cover a portion of gender-affirming surgeries, so it’s worth checking with your insurance provider.

It’s essential to consult directly with surgeons or medical facilities for more accurate cost estimates and to understand what’s included in the quoted prices.