Gender transition surgery from female to male (FTM), also known as gender-affirming or gender-confirming surgery, includes various procedures that individuals might undergo to align their physical appearance with their gender identity. Here’s an overview of surgical options for FTM individuals:

  1. Top Surgery (Chest Masculinization):
    • Bilateral Mastectomy: This procedure involves removing breast tissue and reshaping the chest to give it a more masculine appearance. It is the most common surgical procedure sought by trans men.
    • Nipple and Areola Resizing and Repositioning: Often as part of chest surgery, the nipples and areolae may be resized and repositioned to appear more like cisgender male anatomy.
  2. Hysterectomy:
    • This surgery involves removing the uterus. It can be done using various methods: laparoscopically, abdominally, or vaginally.
  3. Oophorectomy:
    • This refers to the removal of the ovaries. It can be performed in conjunction with a hysterectomy or as a separate procedure.
  4. Vaginectomy:
    • Removal of the vaginal tissue. It is sometimes done in conjunction with bottom surgeries like phalloplasty or metoidioplasty.
  5. Bottom Surgery:
    • Metoidioplasty: Due to testosterone hormone therapy, the clitoris enlarges. In metoidioplasty, the enlarged clitoris is released from some of its ligamentous attachments to increase its prominence, resulting in a small phallus. The surgery often includes urethral lengthening to allow urination through the neophallus.
    • Phalloplasty: This involves constructing a neophallus, typically using skin grafts from parts of the body such as the forearm, thigh, or back. It’s a more intricate procedure and may be done in stages. Urethral lengthening is often part of this surgery.
    • Scrotoplasty: This is the construction of a scrotum, generally using labial tissue. Testicular implants can be placed later to achieve the appearance of testes.
  6. Urethral Lengthening:
    • Often done as part of metoidioplasty or phalloplasty, the urethra is lengthened to allow urination from the tip of the neophallus.
  7. Facial and Other Surgeries:
    • Though testosterone therapy can lead to more masculine features like a deeper voice and facial hair growth, some trans men may choose surgeries like rhinoplasty or thyroid cartilage enhancement (to enhance the Adam’s apple) to further masculinize the face.
  8. Hair Transplantation:
    • Some individuals may seek hair transplants to address male pattern baldness or to create a more typically male hairline.

It’s crucial for those considering these surgeries to consult with experienced surgeons specializing in gender-affirming procedures. Each surgery has its own set of benefits and risks, and discussing expected outcomes, potential complications, and recovery is vital.