The process of changing the physical appearance of the sexual characteristics from male to female is called male-to-female (MtF) gender confirmation surgery, also referred to as sex reassignment surgery or gender reassignment surgery. The specific procedure for creating female genitals is often referred to as vaginoplasty.

The most common type of vaginoplasty for MtF transition is penile inversion, which involves the following steps:

1. Orchiectomy: The removal of the testicles. This stops the body’s main source of testosterone.
2. Penectomy: The removal of the penis, though some of the tissue is typically used to create a neovagina and neoclitoris.
3. Vaginoplasty: The creation of a vaginal canal and opening. The surgeon usually uses skin from the penis and potentially a part of the scrotum to construct the vaginal canal.
4. Clitoroplasty: The creation of a clitoris, which can be sensate, from part of the glans of the penis.
5. Labiaplasty: The creation of labia (the external part of the vagina) from scrotal skin and other tissues.

After the procedure and recovery period, the result should be a neovagina that has a similar appearance to a cisgender woman’s vagina. It’s important to remember that, while this surgery creates a vagina, it does not include a uterus, fallopian tubes, or ovaries. Therefore, menstruation and natural conception and childbirth are not possible.

The surgery is usually followed by a period of dilation, where the patient regularly inserts a dilator into the neovagina to prevent it from narrowing and to maintain its depth.

As always, all surgeries come with risks, so it’s important to discuss these with a healthcare provider. Additionally, not all transgender women choose or can afford to undergo surgery, and their identities are valid regardless of surgical status.

This information is accurate as of my last training in September 2021. Always consult with healthcare professionals to get the most recent and relevant information.