Female-to-male (FTM) bottom surgery, or gender-affirming surgery, can have different outcomes based on the type of surgery pursued, the expertise of the surgeon, the individual’s body, and the care taken during recovery. Here are some general outcomes for healed FTM bottom surgeries:

  1. Metoidioplasty:
    • Appearance: The result is a small phallus created from the clitoral tissue, which has been enlarged due to testosterone therapy. The phallus can resemble a small penis.
    • Function: Sensation is typically retained, and some individuals may be able to achieve erections naturally. Some people may also be able to urinate while standing, especially if urethral lengthening was part of the procedure.
    • Scarring: Minimal scarring might be present depending on any additional procedures (like urethral lengthening) performed alongside metoidioplasty.
  2. Phalloplasty:
    • Appearance: The phallus is constructed using tissue from another part of the body, commonly the forearm, thigh, or back. When healed, the result is a larger phallus that can visually align with the appearance of a cisgender male’s penis.
    • Function: Depending on the specific techniques used and the individual’s healing process, they might be able to urinate standing up. Sexual sensation can vary, with some feeling throughout the phallus and others having sensation concentrated at the base. Additional surgeries may be required to implant erectile devices for sexual intercourse.
    • Scarring: There will be scarring at the donor site (e.g., the forearm, if radial forearm phalloplasty was performed). With proper care, these scars can fade somewhat over time but will remain visible.
  3. Scrotoplasty:
    • Appearance: When healed, the result is a scrotal sac created from the labial tissue. If testicular implants are added, the scrotum will have a more typical male appearance.
    • Function: The scrotum is not functional in terms of producing sperm, but testicular implants can give a natural feel.
    • Scarring: Scarring might be minimal and will typically fade with time.
  4. Vaginectomy:
    • Appearance: The vaginal opening is closed.
    • Function: This procedure eliminates the possibility of vaginal intercourse and menstruation.
    • Scarring: Scarring is typically internal and not visible.

It’s crucial to understand that individual results can vary. Factors like age, overall health, individual anatomy, adherence to post-surgical care, and even genetics can influence the final outcome. Satisfaction rates with FTM bottom surgery are generally high, but as with any surgical procedure, there are potential risks and complications. Proper consultation with a qualified and experienced surgeon and realistic expectations are essential.