The process of transitioning from female to male (FTM), often referred to in medical contexts as “transmasculine” transition, can involve a combination of medical, social, and legal steps. One significant aspect of this transition can be gender-affirming surgeries. Here’s an overview of the surgical procedures that some transgender men or transmasculine individuals might pursue:

  1. Top Surgery (Chest Masculinization Surgery):
    • Mastectomy: This is the removal of breast tissue to create a male-contoured chest. There are several techniques that surgeons might use, depending on breast size, skin elasticity, and patient preference:
      • Double Incision: Common for larger chests; involves removing breast tissue, excess skin, and repositioning the nipples.
      • Keyhole or Peri-areolar: Used for smaller chest sizes; involves smaller incisions and less scarring.
    • The goal is to achieve a natural-looking male chest, with minimal scarring and proper nipple placement.
  2. Hysterectomy:
    • This is the removal of the uterus. There are several types of hysterectomy, including total (removal of the uterus and cervix), subtotal (removal of the uterus but leaving the cervix), and radical (removal of the uterus, cervix, part of the vagina, and surrounding tissues).
  3. Salpingo-oophorectomy:
    • This involves the removal of the ovaries and fallopian tubes. It can be done at the same time as a hysterectomy or as a separate procedure.
  4. Bottom Surgery:
    • Phalloplasty: A procedure where a penis is constructed using skin grafts, typically from the forearm or thigh. This procedure can be complex and often requires multiple stages, including:
      • Creation of the neophallus.
      • Urethral lengthening to allow for urination through the neophallus.
      • Placement of an erectile device or implant for sexual function.
    • Metoidioplasty: This procedure capitalizes on the clitoral growth caused by testosterone therapy. The clitoris is released from its ligamentous attachments to create a neophallus. This results in a smaller phallus than phalloplasty but retains natural sensation and can achieve erections without an implant.
    • Scrotoplasty: This procedure creates a scrotum using labial tissue. Silicone testicular implants can be inserted to give a more typical male appearance.
  5. Other Procedures:
    • Some individuals also pursue surgeries to masculinize other parts of their bodies, such as facial masculinization surgery or body contouring.
  6. Considerations:
    • Fertility: Procedures like hysterectomy and salpingo-oophorectomy render an individual sterile. It’s essential to discuss fertility preservation options, like egg banking, before undergoing these surgeries if having biological children is a future consideration.
    • Risks & Recovery: As with any surgical procedure, there are inherent risks. It’s crucial to work with experienced surgeons and understand the potential complications and recovery timelines.
    • Access & Cost: Accessibility to these surgeries can vary based on geographic location, insurance coverage, and personal finances.

Choosing to undergo any of these surgeries is a deeply personal decision. Not all transgender men or transmasculine individuals will pursue surgery, and that’s okay. What’s most important is that each individual finds the path that feels right for them and seeks out supportive environments and resources.