Gender transition surgery, often referred to as gender-affirming surgery or sex reassignment surgery (SRS), for male-to-female (MTF) transgender individuals encompasses various procedures designed to change primary and secondary sexual characteristics to align more closely with female anatomy and physiology.

Here is an overview of surgical procedures that may be pursued by MTF individuals:

  1. Vaginoplasty:
    • This is the surgical construction of a vagina. The most common technique, known as penile inversion vaginoplasty, involves using skin from the penis and, in some cases, the scrotum to create the vaginal canal.
    • Labiaplasty can be performed simultaneously or in a separate procedure to create the labia majora and minora.
    • A neoclitoris, which can have sensation, is often crafted from a portion of the glans penis.
  2. Orchiectomy:
    • Removal of the testicles. This can be done as a standalone procedure, especially for those who may not want a full vaginoplasty or for those who want to stop taking anti-androgen medications.
  3. Facial Feminization Surgery (FFS):
    • This is a set of reconstructive surgical procedures designed to feminize the face. It can include:
      • Forehead contouring or reduction
      • Jaw and chin contouring
      • Rhinoplasty (nose surgery)
      • Cheek augmentation
      • Tracheal shave (to reduce the Adam’s apple)
      • Brow lift
      • Lip lift or augmentation
  4. Breast Augmentation:
    • While estrogen hormone therapy can lead to breast development, some MTF individuals desire larger breasts than what hormones alone can provide. In such cases, breast implants might be pursued.
  5. Voice Surgery:
    • Some may seek surgery to raise the pitch of their voice. Procedures might involve adjusting the vocal cords or changing the resonance chamber’s size. However, many opt for voice training therapy instead of, or in addition to, surgery for voice modification.
  6. Body Contouring:
    • Procedures like liposuction or fat grafting might be used to redistribute body fat in a more typically feminine pattern, especially in areas like the hips and buttocks.
  7. Hair Transplants:
    • For those experiencing male pattern baldness, hair transplants can be done to create a more typically female hairline.


  • Risks: As with any surgical procedure, gender-affirming surgeries come with risks, including infection, scarring, complications related to anesthesia, dissatisfaction with results, and the potential need for revision surgeries.
  • Preparation: Many international standards, like the WPATH Standards of Care, often require a certain period on hormone therapy and one or two referral letters from mental health professionals before surgery.
  • Post-Operative Care: Some surgeries, especially vaginoplasty, require a significant post-operative care commitment. For example, regular vaginal dilation may be necessary to maintain the depth and width of a newly constructed vagina.
  • Cost and Accessibility: The cost can be a barrier for many, though some health insurance plans and national health systems do cover gender-affirming surgeries. Access can also be limited depending on geographic location.

Individuals considering any form of gender-affirming surgery should have detailed consultations with experienced surgeons to understand the potential risks, benefits, and outcomes. Mental health support can also be beneficial before and after surgery.