Male-to-female (MtF) gender confirmation surgery, also known as sex reassignment surgery, involves several procedures that alter the existing male genitalia to construct female genitalia.

The most common procedure is known as penile inversion vaginoplasty. This involves:

  1. Orchiectomy: Removal of the testes to stop the production of testosterone.
  2. Penectomy: Removal of the penis. Some of the penile tissue is used to construct the vaginal canal and neoclitoris.
  3. Vaginoplasty: The creation of a vagina. The surgeon uses skin from the penis and sometimes a portion of the scrotum to create a neovagina (a surgically constructed vagina).
  4. Labiaplasty: This procedure forms the labia minora and labia majora from scrotal and other skin.
  5. Clitoroplasty: The glans of the penis is typically used to form a neoclitoris. The goal is to preserve sensation.

Please note that these surgeries are complex and not without risk, so a decision to undergo surgery should be made in consultation with experienced healthcare providers.

It’s important to note that while this surgery can create a neovagina and external female genitalia, it does not include a uterus or ovaries, so menstruation and childbirth are not possible. The neovagina does not self-lubricate in the same way as a cisgender female’s vagina, as it doesn’t have the same mucus membranes.

It’s also important to note that not all transgender women choose or can afford to have surgery, and their identities are valid regardless of surgical status.

As always, the information available may have evolved after my last training data in September 2021. Always consult with healthcare professionals to get the most recent and relevant information.