Female-to-male (FTM) genital surgery, also known as phalloplasty, is a surgical procedure that aims to create a neophallus (new penis) for individuals assigned female at birth but who identify as male. Phalloplasty is a complex and multi-stage procedure that typically involves several surgical techniques. It’s important to note that the specific details and techniques used can vary depending on the surgeon and the individual’s specific goals and needs.

Here are some common techniques that may be involved in FTM phalloplasty:
⦁ Phalloplasty Techniques: Phalloplasty can be performed using various techniques, including radial forearm flap, anterolateral thigh flap, and musculocutaneous latissimus dorsi flap. These techniques involve harvesting tissue from different parts of the body to create the neophallus.
⦁ Urethral Lengthening: One of the goals of phalloplasty is to create a functional urinary channel. Urethral lengthening involves extending the urethra to allow for urination through the neophallus. This can enable individuals to urinate while standing.
⦁ Erectile Implants: Some individuals may choose to have erectile implants inserted during phalloplasty to enhance sexual function. These implants allow for the neophallus to become erect when desired.
⦁ Scrotoplasty: Scrotoplasty is a procedure performed during phalloplasty to create a scrotum. This involves shaping and positioning the labial tissue to form a scrotal sac.
⦁ Sensation and Nerve Hook-up: Nerves from the donor site (such as the forearm or thigh) are connected to the neophallus to restore sensation in the newly constructed penis.

It’s important to note that phalloplasty is a complex and highly individualized procedure. It requires a thorough evaluation, discussion, and planning with a qualified surgeon who specializes in transgender healthcare. They can provide detailed information about the different techniques, risks, benefits, potential complications, and expected outcomes based on your specific situation.

It is recommended to seek out experienced surgeons who have a proven track record in performing phalloplasty surgeries, as their expertise can greatly impact the overall results and satisfaction. It’s also crucial to have a support system in place, including mental health professionals and transgender healthcare specialists, to provide guidance and support throughout the surgical process and recovery.

Phalloplasty

Phalloplasty is a surgical procedure performed to construct a penis, typically for transgender men or individuals assigned female at birth who desire male genitalia. It’s a complex and multi-stage surgery that aims to create a functional and aesthetically pleasing penis. Here are the key details about phalloplasty:

1. Purpose: Phalloplasty is performed to alleviate gender dysphoria and help individuals achieve a physical appearance that aligns with their gender identity. It’s an important component of gender-affirming surgery for transgender men.
2. Techniques: There are several techniques for phalloplasty, including:
   • Radial Forearm Phalloplasty: In this method, skin, tissue, and sometimes nerves are taken from the forearm to create the penis. The radial artery is often used to provide blood flow to the newly constructed penis.
   • Anterolateral Thigh (ALT) Phalloplasty: This technique involves using tissue from the thigh to construct the penis.
   • Abdominal Phalloplasty: Tissue from the lower abdomen can be used to create the penis.
   • Gluteal Fold Flap Phalloplasty: Tissue from the buttocks may be used for penile reconstruction.
3. Urethral Lengthening: One of the crucial aspects of phalloplasty is creating a urethra that allows the individual to urinate while standing. Surgeons often perform urethral lengthening during the procedure.
4. Scrotoplasty: Many individuals undergoing phalloplasty also choose to have a scrotum constructed. This can involve using tissue from the labia majora or other donor sites to create a sac-like structure that resembles a scrotum.
5. Erectile Function: Some individuals may opt to have an erectile prosthesis implanted during phalloplasty to enable the ability to achieve erections. This can enhance sexual function and satisfaction.
6. Complications: As with any surgical procedure, there are risks associated with phalloplasty, including infection, bleeding, nerve damage, and complications with wound healing. Patients should thoroughly discuss these risks with their surgeon before undergoing the procedure.
7. Post-surgical Care: Recovery from phalloplasty can be lengthy and may involve multiple follow-up appointments with the surgical team. Patients are typically advised to avoid strenuous activity and heavy lifting during the initial stages of recovery to promote healing.

Phalloplasty is a life-changing procedure for many transgender men, helping them achieve greater alignment between their physical body and gender identity. It’s essential for individuals considering phalloplasty to consult with experienced healthcare providers who specialize in transgender healthcare to discuss their options and expectations thoroughly.

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Female to male

“Female to male” (often abbreviated as “FTM”) refers to individuals who were assigned female at birth but identify and live as male. These individuals may undergo various forms of gender-affirming treatments, including hormone therapy and surgical interventions, to align their physical appearance with their gender identity.

Here are some key details related to female-to-male (FTM) gender transition:

1. Gender Identity: FTM individuals identify as male, regardless of the sex they were assigned at birth. Gender identity is a deeply-held sense of being male, female, or another gender, which may or may not correspond with the sex assigned at birth.
2. Hormone Therapy: Many FTM individuals undergo hormone therapy as part of their transition. Testosterone is typically administered to induce masculinizing effects, such as increased facial and body hair, voice deepening, fat redistribution, and muscle development.
3. Chest Surgery (Top Surgery): One common surgical procedure for FTM individuals is chest surgery, also known as “top surgery” or “mastectomy.” This procedure involves removing breast tissue to create a more masculine chest contour. Some individuals may also opt for nipple reconstruction or chest contouring.
4. Genital Surgery (Bottom Surgery): Some FTM individuals choose to undergo genital surgery, also known as “bottom surgery,” to align their physical anatomy with their gender identity. This may involve procedures such as metoidioplasty or phalloplasty to create a penis and/or scrotum. Urethral lengthening may also be performed to enable urination while standing.
5. Legal and Social Transition: Transitioning for FTM individuals often involves legal and social changes, such as updating identification documents, changing their name and gender marker, and navigating social interactions in alignment with their gender identity.
6. Support and Resources: Support from healthcare professionals, mental health providers, support groups, and peers is crucial for FTM individuals throughout their transition process. Access to affirming healthcare and resources can significantly improve their well-being and quality of life.
7. Challenges and Discrimination: FTM individuals may face various challenges and forms of discrimination, including social stigma, discrimination in healthcare, and difficulties in accessing gender-affirming treatments. It’s essential for society to foster inclusive environments and provide support for transgender individuals.

Overall, the transition process for FTM individuals is deeply personal and varies from person to person. Respect for individuals’ gender identities and access to affirming healthcare and support services are essential for promoting their health and well-being.

Gender-affirming surgery

Gender-affirming surgery, also known as gender-confirming surgery or sex reassignment surgery, is a set of surgical procedures performed to alter an individual’s physical characteristics to better align with their gender identity. These surgeries are typically pursued by transgender and gender nonconforming individuals as part of their gender transition journey. Here are some key details about gender-affirming surgery:

1. Purpose: The primary goal of gender-affirming surgery is to alleviate gender dysphoria—the distress experienced when an individual’s gender identity does not match their assigned sex at birth. By altering physical characteristics, gender-affirming surgery can help individuals achieve a body that reflects their true gender identity, thus improving their psychological well-being and quality of life.
2. Types of Surgeries:

1. • Chest Surgery (Top Surgery): For transgender men (assigned female at birth), chest surgery involves the removal of breast tissue (mastectomy) to create a more masculine chest contour. Transgender women (assigned male at birth) may undergo breast augmentation to achieve a more feminine chest appearance.
   • Genital Surgery (Bottom Surgery): Genital surgeries for transgender individuals vary depending on their desired outcome and may include procedures such as vaginoplasty, metoidioplasty, phalloplasty, orchiectomy, and penectomy. These surgeries involve altering the genitals to align with the individual’s gender identity.

1. Hormone Therapy: Many individuals undergo hormone therapy as part of their gender transition. Hormones such as testosterone and estrogen are administered to induce secondary sex characteristics consistent with the individual’s gender identity. Hormone therapy may precede or follow gender-affirming surgery, depending on the individual’s preferences and medical considerations.
2. Eligibility and Criteria: Eligibility for gender-affirming surgery varies depending on factors such as age, mental health status, readiness, and medical fitness. Mental health assessments and evaluations by healthcare providers specializing in transgender care are typically required to assess an individual’s readiness for surgery.
3. Risks and Complications: Like any surgical procedure, gender-affirming surgery carries risks, including infection, bleeding, anesthesia complications, scarring, and dissatisfaction with surgical outcomes. Patients should thoroughly discuss the potential risks and benefits with their healthcare providers before proceeding with surgery.
4. Post-surgical Care and Recovery: Recovery from gender-affirming surgery varies depending on the type of procedure performed. Patients may experience pain, swelling, and limited mobility in the immediate postoperative period. Follow-up appointments with the surgical team are essential for monitoring healing and addressing any concerns or complications.
5. Legal and Social Implications: Gender-affirming surgery may have legal and social implications, including changes to legal documents such as birth certificates, driver’s licenses, and passports to reflect the individual’s correct gender identity. Additionally, individuals may experience changes in social interactions and relationships following surgery.

FTM bottom surgery

Female-to-male (FTM) bottom surgery, also known as genital reconstruction surgery or phalloplasty, is a surgical procedure performed to create a penis for transgender men or individuals assigned female at birth who desire male genitalia. FTM bottom surgery is a complex and multi-stage process that involves various techniques depending on the desired outcomes of the individual. Here are some key details about FTM bottom surgery:

1. Purpose: FTM bottom surgery aims to alleviate gender dysphoria by aligning the physical appearance of the genitalia with the individual’s gender identity. It can greatly improve the quality of life and well-being of transgender men by allowing them to have a body that reflects their true gender.
2. Types of Procedures:
   • Radial Forearm Phalloplasty: This technique involves using skin, tissue, and sometimes nerves harvested from the forearm to create the penis. The radial artery is often used to provide blood flow to the newly constructed penis.
   • Anterolateral Thigh (ALT) Phalloplasty: In this method, tissue from the thigh is used to construct the penis.
   • Abdominal Phalloplasty: Tissue from the lower abdomen can be used to create the penis.
   • Gluteal Fold Flap Phalloplasty: This technique uses tissue from the buttocks to construct the penis.
3. Urethral Lengthening: One of the primary goals of FTM bottom surgery is to create a functioning urethra that allows the individual to urinate while standing. Surgeons often perform urethral lengthening during the procedure, which involves extending the urethra to the tip of the newly constructed penis.
4. Scrotoplasty: Many individuals undergoing FTM bottom surgery also choose to have a scrotum constructed. This can involve using tissue from the labia majora or other donor sites to create a sac-like structure that resembles a scrotum.
5. Erectile Prosthesis: Some individuals may opt to have an erectile prosthesis implanted during FTM bottom surgery to allow for the ability to achieve erections. This can enhance sexual function and satisfaction.
6. Complications and Risks: As with any surgical procedure, there are risks associated with FTM bottom surgery, including infection, bleeding, nerve damage, and complications with wound healing. Patients should thoroughly discuss these risks with their surgeon before undergoing the procedure.
7. Post-surgical Care and Recovery: Recovery from FTM bottom surgery can be lengthy and may involve multiple follow-up appointments with the surgical team. Patients are typically advised to avoid strenuous activity and heavy lifting during the initial stages of recovery to promote healing.

FTM bottom surgery is a significant and life-changing procedure for transgender men, and it’s essential for individuals considering it to thoroughly discuss their options with qualified healthcare providers who specialize in transgender healthcare. Support from mental health professionals and peer support groups can also be invaluable throughout the surgical journey.

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Genital reconstruction

Genital reconstruction, also known as genital affirming surgery or gender-affirming genital surgery, is a set of surgical procedures performed to alter an individual’s genital anatomy to better align with their gender identity. These procedures are typically pursued by transgender and gender nonconforming individuals as part of their gender transition journey. Here are some key details about genital reconstruction:

1. Purpose: The primary goal of genital reconstruction is to alleviate gender dysphoria—the distress experienced when an individual’s gender identity does not match their assigned sex at birth. By altering the genital anatomy, genital reconstruction can help individuals achieve a body that reflects their true gender identity, thus improving their psychological well-being and quality of life.
2. Types of Surgeries:

1. • Vaginoplasty: This procedure is typically performed for transgender women (assigned male at birth) and involves creating a vagina and vulva using penile and scrotal tissue. The penile skin is used to line the vaginal canal, while the scrotal skin may be used to create the labia majora.
   • Metoidioplasty: Metoidioplasty is a surgical procedure performed for transgender men (assigned female at birth) who have undergone hormone therapy and experienced clitoral enlargement (clitoromegaly). It involves releasing the clitoral ligaments to increase the length of the clitoris, creating a structure that resembles a small penis. Some individuals may also undergo urethral lengthening to enable urination while standing.
   • Phalloplasty: Phalloplasty is a more extensive procedure performed for transgender men who desire a larger and more anatomically complete penis. It involves using tissue from donor sites such as the forearm, thigh, abdomen, or buttocks to construct a penis. Urethral lengthening and scrotoplasty (creation of a scrotum) may also be performed as part of phalloplasty.

1. Eligibility and Criteria: Eligibility for genital reconstruction surgery varies depending on factors such as age, mental health status, readiness, and medical fitness. Mental health assessments and evaluations by healthcare providers specializing in transgender care are typically required to assess an individual’s readiness for surgery.
2. Risks and Complications: Like any surgical procedure, genital reconstruction surgery carries risks, including infection, bleeding, anesthesia complications, scarring, and dissatisfaction with surgical outcomes. Patients should thoroughly discuss the potential risks and benefits with their healthcare providers before proceeding with surgery.
3. Post-surgical Care and Recovery: Recovery from genital reconstruction surgery varies depending on the type of procedure performed. Patients may experience pain, swelling, and limited mobility in the immediate postoperative period. Follow-up appointments with the surgical team are essential for monitoring healing and addressing any concerns or complications.

Genital reconstruction surgery is a critical component of comprehensive transgender healthcare and can have profound positive effects on the lives of transgender and gender nonconforming individuals. Access to affirming healthcare, support from knowledgeable healthcare providers, and acceptance from society are essential for promoting the health and well-being of individuals undergoing genital reconstruction surgery.

Urethral lengthening

Urethral lengthening is a surgical procedure commonly performed as part of genital reconstruction surgery for transgender men (assigned female at birth) or individuals with congenital conditions affecting the genitalia. The procedure is aimed at extending the urethra to allow the individual to urinate while standing, which can enhance their sense of gender affirmation and quality of life. Here are some key details about urethral lengthening:

1. Purpose: The primary goal of urethral lengthening is to create a functional and aesthetically pleasing penis with a urethra that extends to the tip. This allows the individual to urinate while standing, which is often an important aspect of gender affirmation for transgender men.
2. Techniques:

1. • Vaginectomy: In some cases, vaginectomy (removal of the vaginal canal) may be performed prior to urethral lengthening to create space for the new urethra.
   • Tissue Dissection: The surgical team carefully dissects and mobilizes tissue, often from the labia minora or other donor sites, to create a urethral extension.
   • Urethral Reconstruction: The surgeon reconstructs the urethra, ensuring proper alignment and adequate blood supply to the newly created urethral segment.
   • Anastomosis: The newly reconstructed urethra is connected to the existing urethral opening (meatus) at the tip of the penis.

1. Tissue Flaps: Various tissue flaps may be used to lengthen the urethra, including local tissue flaps from the genital region or distant flaps harvested from other parts of the body.
2. Stent Placement: In some cases, a stent may be temporarily placed in the urethra to support healing and maintain the shape of the reconstructed urethra.
3. Postoperative Care: Following surgery, patients typically require a period of catheterization to allow the urethra to heal properly. The catheter is usually removed after a few weeks, and patients are instructed on postoperative care, including hygiene and monitoring for complications such as infection or urinary retention.
4. Complications: As with any surgical procedure, there are risks associated with urethral lengthening, including infection, urinary fistula (abnormal connection between the urethra and surrounding tissues), urethral stricture (narrowing of the urethra), and urinary incontinence. Patients should be thoroughly informed about these risks and undergo careful preoperative assessment to minimize the likelihood of complications.

Urethral lengthening is a significant step in the gender affirmation process for transgender men and can greatly improve their quality of life by allowing them to urinate in a manner that aligns with their gender identity. It’s essential for individuals considering urethral lengthening to consult with experienced healthcare providers specializing in transgender care and to thoroughly discuss their options, expectations, and potential risks before undergoing surgery.

Scrotoplasty

Scrotoplasty is a surgical procedure performed as part of genital reconstruction surgery for transgender men (assigned female at birth) or individuals seeking to align their physical appearance with their male gender identity. The procedure involves the creation or enhancement of a scrotum, the sac-like structure that houses the testes. Here are some key details about scrotoplasty:

1. Purpose: The primary goal of scrotoplasty is to create a scrotum that resembles the male genital anatomy, providing a more masculine appearance to the genital region. For transgender men, scrotoplasty is often performed alongside other procedures, such as phalloplasty or metoidioplasty, to create a more comprehensive male genitalia.
2. Techniques:
   • Local Tissue Flaps: In some cases, scrotoplasty can be performed using tissue flaps from the genital region, such as the labia majora or mons pubis. The tissue is reshaped and repositioned to create the appearance of a scrotum.
   • Implant Placement: Silicone testicular implants may be inserted into the newly created scrotum to provide volume and a more natural appearance. These implants can help achieve symmetry and enhance the aesthetic outcome of the procedure.
3. Size and Shape: The size and shape of the scrotum can be customized to meet the individual’s preferences and aesthetic goals. Surgeons work closely with patients to ensure that the scrotum aligns with their desired appearance and proportions.
4. Placement of Testicular Prosthesis: In addition to creating the scrotal sac, some individuals may opt to have testicular prostheses inserted into the scrotum. These prostheses are typically made of silicone and provide a natural feel and appearance. They can help enhance body image and self-esteem by completing the appearance of the male genitalia.
5. Recovery: Recovery from scrotoplasty varies depending on the specific technique used and any additional procedures performed concurrently. Patients may experience swelling, bruising, and discomfort in the immediate postoperative period. The surgical team provides instructions for postoperative care, including wound care, pain management, and activity restrictions.
6. Complications: As with any surgical procedure, scrotoplasty carries risks, including infection, bleeding, wound dehiscence (opening of the surgical incision), and implant complications. Patients should be thoroughly informed about these risks and undergo careful preoperative assessment to minimize the likelihood of complications.

Scrotoplasty is an important component of gender-affirming surgery for transgender men and individuals seeking to align their physical appearance with their male gender identity. It can greatly improve body image and self-esteem by creating genitalia that better match the individual’s gender identity. As with any surgical procedure, it’s essential for patients to consult with experienced healthcare providers specializing in transgender care and to thoroughly discuss their options, expectations, and potential risks before undergoing scrotoplasty.

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Erectile prosthesis

An erectile prosthesis, also known as a penile implant or penile prosthesis, is a medical device implanted into the penis to treat erectile dysfunction (ED) or to enhance erectile function in individuals who have undergone genital reconstruction surgery, such as phalloplasty. Here are some key details about erectile prostheses:

1. Purpose: The primary goal of an erectile prosthesis is to restore the ability to achieve and maintain erections for sexual intercourse. This is particularly important for individuals who have difficulty achieving erections due to medical conditions such as erectile dysfunction or as a result of surgical procedures that alter the anatomy of the penis, such as phalloplasty.
2. Types of Penile Implants:

1. • Inflatable Penile Implant: This type of implant consists of inflatable cylinders that are surgically inserted into the penis. The cylinders are connected to a pump located in the scrotum or abdominal wall, which the individual can manually activate to inflate the cylinders and achieve an erection. After sexual activity, the pump is deactivated to deflate the cylinders.
   • Semi-Rigid or Malleable Penile Implant: This type of implant consists of bendable rods that are surgically implanted into the penis. The rods allow the penis to be manually positioned in an erect or flaccid state. Unlike inflatable implants, semi-rigid implants do not require a pump and remain in a semi-rigid state at all times.

1. Surgical Procedure: Implantation of an erectile prosthesis is typically performed as a surgical procedure under general anesthesia. The surgeon makes an incision in the penis and inserts the implant components into the erectile chambers (corpora cavernosa). The incision is then closed, and the implant is secured in place.
2. Recovery: Recovery from penile implant surgery varies depending on the type of implant and individual factors. Patients may experience pain, swelling, and bruising in the genital area following surgery. The surgical team provides instructions for postoperative care, including wound care, pain management, and restrictions on sexual activity during the initial healing period.
3. Benefits: Erectile prostheses can provide numerous benefits for individuals with erectile dysfunction or those undergoing genital reconstruction surgery, including:

1. • Restoration of sexual function and satisfaction
   • Improved quality of life and self-esteem
   • Enhancement of intimacy and sexual relationships

1. Risks and Complications: Like any surgical procedure, implantation of an erectile prosthesis carries risks, including infection, bleeding, implant malfunction or failure, erosion of the implant into surrounding tissues, and changes in sensation or orgasm. Patients should thoroughly discuss the potential risks and benefits with their healthcare provider before undergoing surgery.

Transmasculine surgery

Transmasculine surgery refers to a set of surgical procedures aimed at affirming the gender identity of individuals assigned female at birth who identify as male or on the masculine spectrum. These surgeries are part of gender-affirming care for transgender men, non-binary individuals, and other transmasculine individuals. Here are some key details about transmasculine surgeries:

1. Purpose: The primary goal of transmasculine surgery is to alleviate gender dysphoria by aligning the physical appearance of the body with the individual’s gender identity. These surgeries can help individuals feel more comfortable and confident in their bodies and improve their overall well-being.
2. Types of Surgeries:

1. • Chest Surgery (Top Surgery): This is one of the most common surgeries for transmasculine individuals. It involves the removal of breast tissue (mastectomy) to create a more masculine chest contour. Some individuals may also opt for nipple grafting or chest contouring to achieve a more aesthetically pleasing result.
   • Genital Reconstruction (Bottom Surgery): Transmasculine individuals may undergo various types of genital reconstruction surgeries, such as metoidioplasty or phalloplasty, to create male genitalia. These procedures can include urethral lengthening, scrotoplasty (creation of a scrotum), and, in some cases, placement of erectile prostheses.
   • Hysterectomy and Oophorectomy: Some transmasculine individuals may choose to undergo surgical removal of the uterus (hysterectomy) and ovaries (oophorectomy) as part of their transition process. This can help alleviate dysphoria related to reproductive organs and may also be necessary if the individual is taking testosterone therapy.
2. Hormone Therapy: Many transmasculine individuals undergo hormone therapy as part of their transition. Testosterone is typically administered to induce masculinizing effects such as increased facial and body hair growth, voice deepening, fat redistribution, and muscle development.
3. Eligibility and Criteria: Eligibility for transmasculine surgeries varies depending on factors such as age, mental health status, readiness, and medical fitness. Mental health assessments and evaluations by healthcare providers specializing in transgender care are typically required to assess an individual’s readiness for surgery.
4. Risks and Complications: Like any surgical procedure, transmasculine surgeries carry risks, including infection, bleeding, anesthesia complications, scarring, and dissatisfaction with surgical outcomes. Patients should thoroughly discuss the potential risks and benefits with their healthcare providers before undergoing surgery.