Hypospadias is a birth defect in which the urethra (the tube that carries urine from the bladder to outside the body) opens on the underside of the penis instead of at the tip. Hypospadias is more common in boys than in girls.
In transgender people, hypospadias can be a source of gender dysphoria. Gender dysphoria is a feeling of distress or discomfort that can occur when a person’s gender identity does not match their assigned sex. For a transgender man, hypospadias can be a reminder of their assigned sex at birth, and it can make them feel less comfortable in their own skin.

There are a number of different treatment options for hypospadias, including surgery. Surgery can help to correct the position of the urethra and to make the penis look more natural. However, surgery is not always necessary, and some transgender men may choose to live with hypospadias without surgery.
If you are a transgender man with hypospadias, it is important to talk to a healthcare provider who is experienced in treating transgender people. They can help you to discuss your options and to make the best decision for you.

Here are some additional resources that you may find helpful:
⦁ The Trevor Project: https://www.thetrevorproject.org/: The Trevor Project is a national organization that provides crisis intervention and suicide prevention services to LGBTQ youth.
⦁ GLAAD: https://www.glaad.org/: GLAAD is a national organization that works to promote acceptance and understanding of LGBTQ people.
⦁ Trans Lifeline: https://www.translifeline.org/: Trans Lifeline is a national organization that provides crisis intervention and suicide prevention services to transgender people.
⦁ PFLAG: https://pflag.org/: PFLAG is a national organization that provides support and resources to LGBTQ people and their families.

Hypospadias is a congenital condition where the opening of the urethra is located on the underside of the penis instead of at the tip. It is typically diagnosed at birth and is unrelated to an individual’s gender identity.
In the context of transgender individuals, it is important to note that hypospadias itself does not determine a person’s gender identity. Gender identity is an individual’s deeply felt sense of their own gender, which may or may not align with the sex assigned to them at birth.

If an individual assigned male at birth with hypospadias later identifies as transgender and wishes to transition to female, the focus would generally be on addressing their gender dysphoria and aligning their physical characteristics with their affirmed gender identity.

The treatment options and steps for transgender individuals with hypospadias may involve various aspects, such as hormone therapy, social transition, and potentially gender confirmation surgeries like genital reconstruction surgery (vaginoplasty) to create a neovagina. The specific treatment path would depend on the individual’s needs, goals, and discussions with qualified healthcare professionals specializing in transgender healthcare.

It is important for transgender individuals with hypospadias to consult with healthcare professionals experienced in transgender healthcare to receive personalized guidance and support throughout their transition journey. They can provide accurate information, assess individual circumstances, and recommend appropriate treatment options based on the individual’s specific needs and goals.


Hypospadias is a congenital condition where the opening of the urethra (the tube that carries urine from the bladder to outside the body) is located on the underside of the penis rather than at the tip. This condition is present at birth and is one of the most common genital anomalies in males.

Key Points:

  1. Variability:
    • Hypospadias can vary in severity. In some cases, the opening may be near the tip of the penis, while in more severe cases, it may be closer to the base or even in the scrotum.
  2. Incidence:
    • It is estimated that hypospadias occurs in approximately 1 in 200 to 1 in 300 live male births. The exact cause is often unknown, but both genetic and environmental factors may contribute.
  3. Medical Evaluation:
    • Diagnosis typically occurs shortly after birth during a physical examination. The healthcare provider assesses the location of the urethral opening and may order additional tests to determine the severity and associated conditions.
  4. Treatment:
    • Surgical intervention is often recommended to correct hypospadias. The goal of surgery is to reposition the urethral opening to the tip of the penis and create a more typical penile appearance. The timing of surgery may vary based on factors such as the severity of the condition and the child’s overall health.
  5. Transgender Considerations:
    • If an individual with hypospadias later identifies as transgender, the condition itself does not impact their gender identity. Transgender individuals may pursue gender-affirming interventions, such as chest surgery or hormone therapy, but these decisions are unrelated to hypospadias.
  6. Psychosocial Support:
    • Individuals with hypospadias may benefit from psychosocial support, especially during childhood and adolescence. Open communication with healthcare providers, parents, and mental health professionals can help address any concerns or questions.
  7. Long-term Outlook:
    • In many cases, surgical correction of hypospadias is successful, and individuals go on to lead healthy lives. Long-term outcomes depend on the severity of the condition, the success of surgical intervention, and any associated complications.
  8. Interdisciplinary Care:
    • Treatment and care for hypospadias often involve an interdisciplinary team, including pediatric urologists, pediatric surgeons, and other healthcare professionals. Regular follow-up visits may be recommended to monitor the individual’s development.

It’s important to note that discussions about hypospadias and related healthcare decisions should be approached with sensitivity and respect for the individual’s feelings and autonomy, especially if they later identify as transgender. Medical professionals experienced in both urology and transgender healthcare can provide appropriate guidance.


Transgender is an umbrella term used to describe individuals whose gender identity differs from the sex assigned to them at birth. Gender identity is a deeply-felt sense of being male, female, a blend of both, or neither, and may not necessarily align with the individual’s anatomical or chromosomal sex. Transgender people may choose to transition socially, medically, or legally to align their gender presentation with their affirmed gender identity.

Key Points:

  1. Gender Identity:
    • Transgender individuals have a gender identity that does not align with the sex assigned to them at birth. This identity is an integral aspect of who they are.
  2. Gender Expression:
    • Gender expression refers to the way individuals outwardly present their gender through clothing, hairstyles, behavior, and other visible characteristics. It may or may not align with societal expectations based on assigned sex.
  3. Social Transition:
    • Social transition involves making changes in external aspects of life to align with one’s gender identity. This may include changes in name, pronouns, clothing, and overall gender presentation.
  4. Medical Transition:
    • Some transgender individuals may pursue medical interventions as part of their transition. This can include hormone therapy to induce physical changes in the body or gender-affirming surgeries, such as chest or genital surgeries.
  5. Legal Transition:
    • Legal transition involves changing identification documents, such as name and gender marker, to reflect one’s affirmed gender. This process varies by jurisdiction and may have different requirements.
  6. Gender Diversity:
    • Gender identity is diverse, and not all transgender individuals follow the same path or make the same choices in their transition. Some may choose specific aspects of transition, while others may not pursue any medical interventions.
  7. Non-binary and Genderqueer Identities:
    • Not all transgender individuals identify strictly as male or female. Some may identify as non-binary, genderqueer, genderfluid, or other gender identities outside the binary.
  8. Support and Community:
    • Many transgender individuals seek support and community within LGBTQ+ circles, transgender support groups, and online forums. Connecting with others who share similar experiences can be valuable.
  9. Gender Dysphoria:
    • Gender dysphoria is the distress that may accompany the incongruence between one’s gender identity and assigned sex at birth. Not all transgender individuals experience gender dysphoria, and its intensity can vary.
  • Legal Protections and Rights:
    • Advocacy efforts have led to increased legal protections for transgender individuals in many places. However, legal rights and protections can vary, and some transgender individuals still face discrimination.
  • Allyship and Education:
    • Allies play a crucial role in supporting transgender individuals by fostering understanding, advocating for inclusivity, and challenging stereotypes and discrimination.

Respecting the identity and autonomy of transgender individuals is essential for creating a more inclusive and affirming society. Understanding the diverse experiences within the transgender community promotes empathy and helps break down societal barriers.

Gender-affirming surgery

  1. Types of Gender-Affirming Surgeries:
    • There are various types of gender-affirming surgeries tailored to different aspects of the body. For transgender men (assigned female at birth), procedures may include chest surgery (mastectomy) and genital reconstruction (phalloplasty or metoidioplasty). For transgender women (assigned male at birth), procedures may include breast augmentation and genital reconstruction (vaginoplasty).
  1. Chest Surgery (Top Surgery):
    • Transgender men often undergo chest surgery to remove breast tissue and create a more masculine chest contour. This is commonly referred to as “top surgery.”
  1. Genital Reconstruction:
    • Genital reconstruction surgeries aim to align an individual’s genitals with their gender identity. Transgender women may undergo vaginoplasty, while transgender men may choose phalloplasty or metoidioplasty.
  1. Hormone Therapy:
    • Prior to or in conjunction with surgery, many transgender individuals undergo hormone therapy. Testosterone is commonly prescribed for transgender men, while estrogen and anti-androgens are prescribed for transgender women. Hormone therapy induces secondary sex characteristics associated with the affirmed gender.
  1. Eligibility and Readiness Assessments:
    • Before undergoing gender-affirming surgery, individuals typically undergo comprehensive assessments to ensure they are physically and psychologically prepared. These assessments may include evaluations by mental health professionals, endocrinologists, and surgeons.
  1. Social Transition:
    • Gender-affirming surgery is often part of a broader process that may include social transition. Social transition involves changes in name, pronouns, and gender expression to align with one’s affirmed gender identity.
  1. Postoperative Recovery:
    • Recovery from gender-affirming surgery varies depending on the type of procedure. Surgeons provide specific postoperative care instructions, and individuals may need time off work or other activities during the recovery period.
  1. Risks and Complications:
    • Like any surgical procedure, gender-affirming surgeries carry risks and potential complications. These can include infection, bleeding, scarring, and changes in sensation. Surgeons discuss these risks during the informed consent process.
  1. Insurance Coverage:
    • The availability of insurance coverage for gender-affirming surgeries varies by location and insurance provider. Advocacy efforts have sought to improve access to gender-affirming care.
  1. Legal Recognition:
    • Some jurisdictions require individuals to undergo gender-affirming surgery to update identification documents (such as gender markers) to reflect their affirmed gender. However, legal recognition practices are evolving, and not all individuals pursue surgery for legal recognition.
  1. Global Variances:
    • Access to gender-affirming surgery and the legal recognition of gender identity vary globally. Cultural, legal, and medical norms influence the availability and acceptance of these procedures.

Gender-affirming surgery is a personal decision, and individuals may choose different paths in their gender transition journey. It is crucial for individuals to have access to informed, compassionate healthcare providers and support systems throughout the process.


Urological conditions

Urological conditions refer to health issues and disorders that affect the urinary system and male reproductive organs. Urology is the medical specialty focused on the diagnosis and treatment of such conditions. Here are some key urological conditions:

  1. Urinary Tract Infections (UTIs):
    • UTIs are infections that can occur in any part of the urinary system, including the bladder, kidneys, ureters, and urethra. They are more common in women but can affect individuals of any gender.
  2. Kidney Stones:
    • Kidney stones are hard deposits that form in the kidneys and can cause severe pain when passing through the urinary tract. The composition of kidney stones can vary.
  3. Benign Prostatic Hyperplasia (BPH):
    • BPH is a non-cancerous enlargement of the prostate gland, which can cause urinary symptoms such as difficulty urinating, increased frequency, and a sense of incomplete emptying.
  4. Prostatitis:
    • Prostatitis is inflammation of the prostate gland. It can be acute or chronic and may cause pain, discomfort, and urinary symptoms.
  5. Erectile Dysfunction (ED):
    • ED is the inability to achieve or maintain an erection sufficient for sexual activity. While it can have psychological causes, urological conditions such as vascular issues may contribute.
  6. Urinary Incontinence:
    • Urinary incontinence is the involuntary leakage of urine. It can result from various factors, including weakened pelvic muscles, nerve damage, or prostate issues.
  7. Bladder Cancer:
    • Bladder cancer can develop in the lining of the bladder. It often presents with blood in the urine, and treatment may involve surgery, chemotherapy, or immunotherapy.
  8. Testicular Cancer:
    • Testicular cancer is a type of cancer that occurs in the testicles. It is more common in young men, and early detection and treatment can be highly effective.
  9. Hypospadias:
    • Hypospadias is a congenital condition where the opening of the urethra is on the underside of the penis rather than at the tip. It is typically present at birth and may require surgical correction.
  • Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS):
    • IC/BPS is a chronic condition characterized by pelvic pain and urinary symptoms. The exact cause is unknown, and management may involve lifestyle changes and medications.
  • Renal Failure:
    • Renal failure, or kidney failure, occurs when the kidneys are no longer able to function adequately. It can be acute or chronic and may require dialysis or kidney transplantation.
  • Male Infertility:
    • Urological conditions, such as varicocele or obstruction of the reproductive tract, can contribute to male infertility. Treatment options depend on the underlying cause.
  • Cryptorchidism:
    • Cryptorchidism is a condition where one or both testicles fail to descend into the scrotum. It is common in newborns and may require surgical correction.
  • Overactive Bladder (OAB):
    • OAB is characterized by a sudden and uncontrollable urge to urinate, often accompanied by frequency and urgency. It can significantly impact quality of life.
  • Sexually Transmitted Infections (STIs):
    • Some STIs can affect the urogenital system, leading to conditions such as urethritis or proctitis.

Management and treatment of urological conditions vary depending on the specific condition and its severity. Individuals experiencing symptoms or concerns related to urological health should seek medical advice for proper evaluation and care. Urologists specialize in diagnosing and treating these conditions.

Gender identity

Gender identity is an individual’s deeply-felt sense of their own gender, which may or may not align with the sex assigned to them at birth. It is an internal and personal understanding of being male, female, both, neither, or a different gender entirely. Gender identity is distinct from biological sex and may be fluid or non-binary.

Hypospadias: Hypospadias is a congenital condition where the opening of the urethra is on the underside of the penis rather than at the tip. It is typically present at birth and is unrelated to an individual’s gender identity. The condition is considered a urological issue, and treatment often involves surgical correction to reposition the urethral opening.

Intersection of Hypospadias and Transgender Identity:

  1. Non-Impact on Gender Identity:
    • Hypospadias itself does not determine an individual’s gender identity. Transgender individuals may have hypospadias, but the two aspects of identity are separate. Gender identity is about how an individual perceives and experiences their own gender.
  2. Transgender Individuals and Urological Concerns:
    • Transgender individuals, like cisgender individuals, may experience a range of urological conditions, including hypospadias. If an individual with hypospadias later identifies as transgender, it is essential to approach their healthcare with sensitivity to both their urological needs and gender identity.
  3. Gender-Affirming Care:
    • Some transgender individuals pursue gender-affirming care, which may include medical interventions like hormone therapy or gender-affirming surgeries. These interventions are separate from addressing urological conditions like hypospadias.
  4. Inclusive and Respectful Healthcare:
    • Healthcare providers should adopt an inclusive and respectful approach when addressing the medical needs of transgender individuals with urological conditions. Communication should prioritize the patient’s gender identity, and discussions about any medical history, including hypospadias, should be conducted with sensitivity and confidentiality.
  5. Patient-Centered Approach:
    • A patient-centered approach is crucial in addressing the healthcare needs of transgender individuals. This involves understanding the unique experiences and considerations related to both gender identity and any concurrent medical conditions.
  6. Mental Health and Support:
    • Transgender individuals may face unique mental health challenges related to their gender identity. Urological conditions, such as hypospadias, can also impact mental well-being. Supportive healthcare includes addressing mental health concerns and connecting individuals with appropriate resources and counseling.

In summary, hypospadias and transgender identity are distinct aspects of an individual’s experience. Providing comprehensive and inclusive healthcare involves recognizing and respecting both the urological needs and gender identity of transgender individuals, creating an environment where they can receive care that aligns with their overall well-being.

Congenital conditions

Congenital conditions, also known as congenital disorders or birth defects, are health issues that are present at or before birth. These conditions can affect various aspects of the body’s structure or function and may be caused by genetic factors, environmental influences, or a combination of both. Here are key points about congenital conditions:

  1. Genetic and Environmental Causes:
    • Congenital conditions can result from genetic factors, such as inherited gene mutations, chromosomal abnormalities, or environmental influences during pregnancy, such as exposure to certain medications, infections, or toxins.
  2. Diverse Range:
    • Congenital conditions can affect different organs and systems, leading to a diverse range of health issues. Examples include heart defects, neural tube defects, limb abnormalities, and genetic syndromes.
  3. Prevalence and Incidence:
    • The prevalence and incidence of congenital conditions vary widely. Some conditions are relatively common, while others are rare. Advances in medical science have improved the diagnosis and management of many congenital conditions.
  4. Early Detection:
    • Some congenital conditions can be detected before birth through prenatal screening and diagnostic tests. Early detection allows healthcare providers to plan appropriate care and interventions.
  5. Treatment and Management:
    • The treatment and management of congenital conditions depend on the specific nature and severity of the condition. Some conditions may require surgical interventions, medications, physical therapy, or a combination of treatments.
  6. Multidisciplinary Care:
    • Many congenital conditions require care from a multidisciplinary team of healthcare professionals. This team may include pediatricians, geneticists, surgeons, therapists, and other specialists.
  7. Lifelong Impact:
    • While some congenital conditions can be successfully treated or managed, others may have a lifelong impact on an individual’s health and well-being. Regular medical follow-ups and ongoing care may be necessary.
  8. Support for Families:
    • Families of individuals with congenital conditions may benefit from support groups, counseling, and resources that provide information and guidance. Navigating the challenges of caring for a child with a congenital condition can be emotionally and physically demanding.
  9. Technological Advances:
    • Advances in medical technology, including prenatal imaging and genetic testing, have improved the ability to detect congenital conditions early in pregnancy, enabling informed decision-making and early interventions.
  • Public Health Efforts:
    • Public health initiatives focus on preventing congenital conditions through measures such as folic acid supplementation, vaccination programs, and education about environmental factors that may impact fetal development.
  • Inclusive and Supportive Environments:
    • Creating inclusive and supportive environments is essential for individuals with congenital conditions. Promoting awareness, reducing stigma, and fostering inclusion contribute to a more inclusive society.
  • Research and Innovation:
    • Ongoing research and innovation in medical science aim to better understand the causes of congenital conditions, develop effective treatments, and improve outcomes for individuals affected by these conditions.

Understanding and addressing congenital conditions require a collaborative effort involving healthcare providers, families, researchers, and the broader community to provide optimal care and support for affected individuals.

Urethral opening

Urethral Opening:

The urethral opening is the external opening through which urine is expelled from the body. It is a part of the urinary system, responsible for the elimination of urine produced by the kidneys. In males and females, the anatomy of the urethral opening differs:

  1. Male Urethral Opening:
    • In males, the urethral opening is located at the tip of the penis. It serves a dual function for both the urinary and reproductive systems. The male urethra extends from the bladder through the penis and carries both urine and semen.
  1. Female Urethral Opening:
    • In females, the urethral opening is situated anterior to the vaginal opening. It is a separate opening from the vagina. The female urethra is shorter than the male urethra and is solely dedicated to the elimination of urine.
  1. Hypospadias:
    • Hypospadias is a congenital condition where the urethral opening in males is not at the typical location at the tip of the penis but rather on the underside. The severity of hypospadias can vary, and surgical correction is often recommended to reposition the urethral opening.
  1. Urological Health:
    • The health of the urethral opening is essential for proper urinary function. Infections, inflammation, or structural abnormalities can impact the urethra and may lead to symptoms such as pain during urination, frequent urination, or difficulty emptying the bladder.
  1. Urethral Stricture:
    • A urethral stricture is a narrowing of the urethra that can impede the flow of urine. It can result from inflammation, injury, or scar tissue formation. Treatment may involve dilation or surgical correction.
  1. Urethral Meatus:
    • The external opening of the urethra is often referred to as the urethral meatus. The appearance and position of the urethral meatus can vary, and any concerns about its location or function should be addressed with a healthcare professional.
  1. Urological Procedures:
    • Certain medical procedures, such as urethral catheterization, involve inserting a thin tube (catheter) through the urethral opening to drain urine from the bladder. This procedure is commonly used in healthcare settings for various purposes.
  1. Maintaining Urological Health:
    • Proper hygiene around the urethral opening is important for maintaining urological health and preventing urinary tract infections. Drinking an adequate amount of water and seeking medical attention for any concerning symptoms are also essential components of urological care.

Understanding the normal anatomy and function of the urethral opening is crucial for assessing and managing urological health. Any concerns or symptoms related to the urethra should be discussed with a healthcare provider for appropriate evaluation and intervention.


Genital reconstruction

Genital Reconstruction:

Genital reconstruction, also known as gender-affirming genital surgery or gender confirmation surgery, is a set of surgical procedures designed to alter the genitals to be more congruent with an individual’s affirmed gender identity. These procedures are a crucial aspect of gender-affirming care for transgender individuals who seek to align their physical characteristics with their gender identity. The specific procedures vary based on the gender identity of the individual:

  1. Transgender Women (Male to Female, MTF):
    • Vaginoplasty: This is the primary surgical procedure for transgender women. It involves creating a neovagina using penile and scrotal tissue. The surgeon reshapes the tissues to form a functional and aesthetically pleasing vaginal structure.
    • Labiaplasty: In conjunction with vaginoplasty, labiaplasty may be performed to create labia minora and majora, enhancing the external appearance of the genitalia.
    • Orchiectomy: Some transgender women undergo orchiectomy, the removal of the testicles, as a separate procedure before or in conjunction with vaginoplasty.
  2. Transgender Men (Female to Male, FTM):
    • Phalloplasty: This is the primary surgical procedure for transgender men seeking genital reconstruction. Phalloplasty involves creating a neophallus using tissue grafts, typically from the forearm or thigh. Additional procedures may be performed to construct the urethra and enable voiding through the neophallus.
    • Metoidioplasty: An alternative to phalloplasty, metoidioplasty involves releasing the hormonally enlarged clitoris (resulting from testosterone therapy) to create a small neophallus. It may also include procedures to extend the urethra.
    • Hysterectomy and Salpingo-Oophorectomy: Some transgender men undergo these procedures, which involve the removal of the uterus, cervix, and ovaries. While not directly related to genital reconstruction, they are part of gender-affirming care.
  3. Non-Binary and Genderqueer Individuals:
    • Genital reconstruction procedures for non-binary and genderqueer individuals vary widely and are highly individualized. Some may choose specific aspects of genital reconstruction, while others may not pursue surgical interventions.

Key Considerations:

  1. Eligibility and Readiness Assessment:
    • Individuals seeking genital reconstruction typically undergo thorough psychological and medical assessments to ensure they are mentally and physically prepared for the procedures.
  2. Hormone Therapy:
    • Many individuals undergo hormone therapy as part of their gender-affirming care before considering genital reconstruction. Hormones play a role in secondary sex characteristic development.
  3. Surgical Techniques and Options:
    • Surgical techniques continue to advance, offering a range of options for individuals based on their anatomy, preferences, and desired outcomes.
  4. Recovery and Postoperative Care:
    • Recovery varies depending on the specific procedures performed. Postoperative care includes follow-up appointments, dilation (for vaginal procedures), and ongoing support from healthcare professionals.
  5. Risks and Complications:
    • As with any surgical procedures, there are risks and potential complications. Surgeons discuss these risks during the informed consent process, and individuals are informed about what to expect.
  6. Psychosocial Support:
    • Genital reconstruction is a significant aspect of a transgender individual’s journey. Psychosocial support, including counseling and support groups, can be crucial for individuals before and after surgery.

Genital reconstruction is a personal decision, and individuals may choose different paths based on their gender identity and goals. Access to knowledgeable and experienced healthcare providers who specialize in transgender care is essential for providing comprehensive support throughout the process.