The surgical procedure that transforms the penis into a vagina is called “vaginoplasty” or “male-to-female (MTF) genital reconstructive surgery.” It’s one of the surgeries transgender women might choose as part of their gender transition. Here’s an overview of the procedure:

Procedure:

1. Orchiectomy: Removal of the testicles.
2. Penectomy: Removal of a portion of the penile tissue. The skin from the penis is often inverted and used to form the vaginal lining.
3. Creation of the Vaginal Canal: A space is created between the rectum and the bladder where the neovagina (newly constructed vagina) will reside.
4. Clitoroplasty: A clitoris is fashioned, often from a section of the glans penis, allowing for erogenous sensation. The nerves are preserved to retain sensitivity.
5. Labiaplasty: Creation of the labia (vaginal lips) using scrotal and other penile skin.
6. Urethral Shortening: The male urethra is shortened and repositioned so that it opens in a location similar to cisgender women.

Postoperative Care:

• Dilation: After the surgery, regular vaginal dilation is required to prevent the neovagina from narrowing or closing. Dilation involves inserting and holding in place special stents of increasing size to maintain the depth and width of the vagina.
• Recovery: Initial recovery often involves a hospital stay of several days. It might take a few weeks before returning to daily activities and several months for full recovery.
• Sexual Sensation: Sexual sensation is preserved in most cases, and many individuals can achieve orgasm after recovery.

Potential Complications:

• Stricture: Narrowing of the vaginal canal, which can make dilation or penetrative intercourse difficult.
• Fistula: An unintended hole that forms between the neovagina and the rectum or urethra. This can result in urine or feces entering the vaginal canal.
• Necrosis: Tissue death, which can occur if blood flow to the newly constructed areas is compromised.
• Granulation tissue: Overproduction of tissue in the surgical area, which might require treatment.
• Decreased or altered sensation: This can impact the clitoris or the neovagina.
• Aesthetic Concerns: Some individuals may desire revision surgeries if they’re not satisfied with the appearance.

Additional Considerations:

• Not all transgender women opt for vaginoplasty. Some may choose alternative surgeries, like an orchiectomy alone or a vulvoplasty (creation of external female genitalia without a vaginal canal). Others might forego surgical interventions entirely.
• Psychological and emotional support before and after surgery is beneficial. Many surgical centers require a letter (or letters) from mental health professionals verifying the individual’s readiness and suitability for surgery.

If considering this procedure, it’s essential to consult with experienced surgeons, understand the risks and benefits, and set realistic expectations.

Vaginoplasty

Vaginoplasty is a surgical procedure performed to construct or reconstruct a vagina. This procedure is often part of gender confirmation surgery for individuals undergoing male-to-female (MTF) transition. It aims to create a functional and aesthetically pleasing vagina, allowing the person’s physical appearance to align more closely with their gender identity. Here are some key details about vaginoplasty:

1. Procedure Types:
   • Penile Inversion Technique: The most common method involves using the penile and scrotal tissue to create the neovagina. The penis is inverted to form the vaginal canal.
   • Non-Penile Inversion Techniques: Some surgeons use alternative methods, such as intestinal or peritoneal grafts, to create the vaginal lining.
2. Preparation:
   • Before surgery, individuals typically undergo psychological evaluations and hormonal therapy as part of the gender transition process.
3. Surgical Process:
   • The surgery involves removing the penis and reshaping the genital area to form the labia and clitoris.
   • The urethra is often repositioned to allow for a more natural location within the neovagina.
   • The surgery may include the removal of the testicles (orchidectomy).
4. Vaginal Depth:
   • The depth of the neovagina varies, and surgeons work to achieve adequate depth for sexual penetration. Dilators may be used postoperatively to maintain the depth.
5. Recovery:
   • Recovery time varies, but patients typically need several weeks to heal.
   • Dilator use is crucial during the recovery period to prevent stenosis (narrowing) of the neovagina.
6. Risks and Complications:
   • As with any surgery, there are risks, including infection, bleeding, and complications related to anesthesia.
   • Long-term complications can include neovaginal stenosis, fistulas, or changes in sensation.
7. Postoperative Care:
   • Post-surgery, patients may require ongoing care, including dilation exercises, follow-up appointments, and possible additional surgeries for refinement.
8. Psychosocial Support:
   • Vaginoplasty is a significant step in the gender affirmation process, and individuals often benefit from counseling and support groups to address psychological and emotional aspects.

It is crucial to note that every person’s experience with vaginoplasty is unique, and outcomes can vary based on factors such as surgical technique, individual anatomy, and postoperative care. Additionally, advancements in surgical techniques continue to evolve, offering improved outcomes and reduced complications. As with any medical procedure, individuals considering vaginoplasty should consult with experienced healthcare professionals to make informed decisions about their care.

Gender confirmation surgery

Gender confirmation surgery, also known as gender-affirming surgery or sex reassignment surgery (SRS), refers to a set of medical procedures designed to help individuals align their physical characteristics with their gender identity. The specific procedures may vary depending on whether the person is transitioning from male to female (MTF) or female to male (FTM). Here are some details:

Male-to-Female (MTF) Gender Confirmation Surgery:

1. Vaginoplasty:

1. • As mentioned earlier, this involves the construction of a neovagina using penile and scrotal tissue.
   • The surgery may include removal of the testicles (orchidectomy).
   • The urethra is often repositioned for a more natural location.

2. Breast Augmentation:

1. • MTF individuals may undergo breast augmentation surgery to achieve a more feminine chest contour.

3. Facial Feminization Surgery (FFS):

1. • FFS includes a range of surgical procedures to soften masculine facial features, such as rhinoplasty, brow lift, and jaw contouring.

4. Tracheal Shave:

1. • This procedure reduces the prominence of the Adam’s apple, contributing to a more feminine appearance.

Female-to-Male (FTM) Gender Confirmation Surgery:

1. Chest Reconstruction (Top Surgery):

1. • FTM individuals often undergo chest reconstruction surgery to remove breast tissue and create a more masculine chest contour.

2. Hysterectomy and Oophorectomy:

1. • Removal of the uterus and ovaries is common to eliminate menstrual cycles and reduce estrogen production.

3. Metoidioplasty:

1. • This procedure involves releasing the clitoris to increase its size, creating a structure that resembles a small penis.

4. Phalloplasty:

1. • Phalloplasty is a more complex procedure that constructs a penis using skin grafts, often from the forearm or thigh.

5. Scrotoplasty:

1. • This involves creating a scrotum, typically using labial tissue, to house testicular implants.

General Considerations:

1. Hormone Therapy:

1. • Many individuals undergo hormone therapy as part of their gender confirmation process, which may involve testosterone for FTMs or estrogen and anti-androgens for MTFs.

2. Mental Health Support:

1. • Psychosocial support, including counseling and support groups, is often an integral part of the gender confirmation process.

3. Legal and Social Aspects:

1. • Some individuals may change their legal gender marker and name as part of their social transition.

4. Postoperative Care:

1. • Recovery varies depending on the procedures performed, and ongoing care, including follow-up appointments and possible revisions, may be necessary.

It’s important to recognize that not every transgender individual pursues gender confirmation surgery, and the decision is highly personal. Each person’s journey is unique, and the procedures chosen depend on individual preferences, medical considerations, and desired outcomes. Access to gender-affirming care may vary, and consultation with experienced healthcare professionals is crucial for informed decision-making.

 

Male-to-female (MTF) surgery

Gender confirmation surgery, also known as gender-affirming surgery or sex reassignment surgery (SRS), refers to a set of medical procedures designed to help individuals align their physical characteristics with their gender identity. The specific procedures may vary depending on whether the person is transitioning from male to female (MTF) or female to male (FTM). Here are some details:

Male-to-Female (MTF) Gender Confirmation Surgery:

1. Vaginoplasty:

1. • As mentioned earlier, this involves the construction of a neovagina using penile and scrotal tissue.
   • The surgery may include removal of the testicles (orchidectomy).
   • The urethra is often repositioned for a more natural location.

2. Breast Augmentation:

1. • MTF individuals may undergo breast augmentation surgery to achieve a more feminine chest contour.

3. Facial Feminization Surgery (FFS):

1. • FFS includes a range of surgical procedures to soften masculine facial features, such as rhinoplasty, brow lift, and jaw contouring.

4. Tracheal Shave:

1. • This procedure reduces the prominence of the Adam’s apple, contributing to a more feminine appearance.

Female-to-Male (FTM) Gender Confirmation Surgery:

1. Chest Reconstruction (Top Surgery):

1. • FTM individuals often undergo chest reconstruction surgery to remove breast tissue and create a more masculine chest contour.

2. Hysterectomy and Oophorectomy:

1. • Removal of the uterus and ovaries is common to eliminate menstrual cycles and reduce estrogen production.

3. Metoidioplasty:

1. • This procedure involves releasing the clitoris to increase its size, creating a structure that resembles a small penis.

4. Phalloplasty:

1. • Phalloplasty is a more complex procedure that constructs a penis using skin grafts, often from the forearm or thigh.

5. Scrotoplasty:

1. • This involves creating a scrotum, typically using labial tissue, to house testicular implants.

General Considerations:

1. Hormone Therapy:

1. • Many individuals undergo hormone therapy as part of their gender confirmation process, which may involve testosterone for FTMs or estrogen and anti-androgens for MTFs.

2. Mental Health Support:

1. • Psychosocial support, including counseling and support groups, is often an integral part of the gender confirmation process.

3. Legal and Social Aspects:

1. • Some individuals may change their legal gender marker and name as part of their social transition.

4. Postoperative Care:

1. • Recovery varies depending on the procedures performed, and ongoing care, including follow-up appointments and possible revisions, may be necessary.

It’s important to recognize that not every transgender individual pursues gender confirmation surgery, and the decision is highly personal. Each person’s journey is unique, and the procedures chosen depend on individual preferences, medical considerations, and desired outcomes. Access to gender-affirming care may vary, and consultation with experienced healthcare professionals is crucial for informed decision-making.

 

Neovaginoplasty

Certainly, “neovaginoplasty” refers to the surgical construction or reconstruction of a neovagina, which is an artificial vagina. This procedure is commonly performed as part of male-to-female (MTF) gender confirmation surgery. Here are key details about neovaginoplasty:

Techniques:

1. Penile Inversion Technique:
   • Description: This is the most common technique, where the penile and scrotal tissues are used to create the neovagina.
   • Procedure: The penis is inverted to form the vaginal canal, and the scrotal tissue is often utilized for the labia.
2. Non-Penile Inversion Techniques:
   • Description: In some cases, alternative methods are employed, such as using intestinal or peritoneal grafts to create the neovagina.

Surgical Steps:

1. Orchidectomy (Testicle Removal):
   • Description: In some cases, neovaginoplasty involves the removal of the testicles (orchidectomy) to reduce testosterone production.
2. Vaginal Canal Creation:
   • Description: The surgeon creates a space for the vaginal canal using the inverted penile tissue, ensuring proper depth and dimensions.
3. Clitoroplasty:
   • Description: A clitoris is often constructed using penile or other available tissue to provide a more natural appearance.
4. Labia Construction:
   • Description: The labia majora and minora are shaped using scrotal and penile tissues, contributing to the external aesthetics.
5. Urethral Repositioning:
   • Description: The urethra is repositioned to a more natural location within the neovagina.

Postoperative Care:

1. Dilation Exercises:
   • Purpose: Dilation is crucial to maintaining the depth and width of the neovagina.
   • Frequency: Patients are typically instructed to perform dilation exercises regularly, starting with larger dilators and gradually progressing.
2. Recovery Period:
   • Duration: The recovery period varies but may involve restrictions on physical activities for several weeks.
   • Follow-up Appointments: Regular follow-up appointments are scheduled to monitor healing and address any concerns.

Risks and Considerations:

1. Infection and Bleeding:
   • Risks: As with any surgery, there is a risk of infection and bleeding.
2. Neovaginal Stenosis:
   • Description: This refers to the narrowing of the neovaginal canal and may require intervention or additional dilation.
3. Psychosocial Support:
   • Importance: Patients may benefit from psychological support to address emotional and social aspects of their transition.

Patient Selection:

1. Evaluation:
   • Psychological Assessment: Individuals typically undergo psychological assessments before surgery to ensure they are well-prepared for the process.
2. Hormone Therapy:
   • Preparation: Many patients undergo hormone therapy as part of the gender affirmation process before surgery.
3. Individualized Approach:
   • Tailoring Treatment: The surgical approach is often customized based on the individual’s anatomy, goals, and overall health.

It’s crucial for individuals considering neovaginoplasty to consult with experienced healthcare professionals who specialize in transgender care. This ensures comprehensive preoperative evaluation, informed decision-making, and appropriate postoperative care.

 

Genital reconstruction surgery

Genital reconstruction surgery, also known as gender-affirming surgery or sex reassignment surgery (GRS), encompasses a range of procedures designed to align an individual’s physical characteristics with their gender identity. This surgery is a crucial step for many transgender individuals seeking to affirm their gender. The specific procedures vary depending on the direction of transition, whether male-to-female (MTF) or female-to-male (FTM). Here are details on genital reconstruction surgery for both MTF and FTM individuals:

Male-to-Female (MTF) Genital Reconstruction:

1. Vaginoplasty:
   • Description: The primary surgery for MTF individuals, vaginoplasty involves creating a neovagina using penile and scrotal tissues.
   • Techniques: Common techniques include the penile inversion method and non-penile inversion methods, such as using intestinal or peritoneal grafts.
2. Orchiectomy:
   • Description: Removal of the testicles is often performed to reduce testosterone production.
   • Timing: Orchiectomy may be done as a standalone procedure or as a preliminary step before vaginoplasty.
3. Clitoroplasty:
   • Description: Construction of a clitoris using penile or other available tissue to enhance external aesthetics.

Female-to-Male (FTM) Genital Reconstruction:

1. Chest Reconstruction (Top Surgery):
   • Description: Removal of breast tissue to create a more masculine chest contour.
   • Techniques: Double incision with nipple grafts and periareolar incision are common methods.
2. Hysterectomy and Oophorectomy:
   • Description: Removal of the uterus and ovaries to eliminate menstrual cycles and reduce estrogen production.
3. Phalloplasty:
   • Description: A complex procedure creating a penis using skin grafts, often from the forearm or thigh.
   • Options: Different types include radial forearm flap, anterolateral thigh flap, and others.
4. Metoidioplasty:
   • Description: This procedure releases the clitoris to increase its size, creating a structure that resembles a small penis.
5. Scrotoplasty:
   • Description: Construction of a scrotum, typically using labial tissue, to house testicular implants.

Considerations for Both MTF and FTM:

1. Urethral Lengthening:
   • Description: Repositioning of the urethra for a more natural location.
   • Purpose: Aims to allow for a standing urination position.
2. Glansplasty (MTF) and Glansplasty (FTM):
   • Description: Construction of a glans for MTF individuals during vaginoplasty and for FTM individuals during phalloplasty.
3. Hair Removal:
   • Description: Preoperative hair removal procedures (electrolysis or laser) may be recommended for specific surgeries.

Postoperative Care and Recovery:

1. Dilation Exercises:
   • Purpose: Ensures the depth and width of the neovagina or neophallus.
   • Frequency: Regular dilation exercises are crucial during the recovery period.
2. Follow-Up Appointments:
   • Importance: Regular check-ups with healthcare professionals are necessary to monitor healing and address any complications.
3. Psychosocial Support:
   • Importance: Emotional and psychological support is essential, and individuals may benefit from counseling or support groups.

It’s important to note that not every transgender individual pursues genital reconstruction surgery, and the decision is highly personal. Access to gender-affirming care may vary, and individuals considering such procedures should consult with experienced healthcare professionals specializing in transgender care. Comprehensive preoperative evaluation and ongoing support are critical components of the overall care process.

 

Sex reassignment surgery (SRS)

Sex reassignment surgery (SRS), also known as gender confirmation surgery or gender-affirming surgery, is a set of medical procedures that aim to align an individual’s physical characteristics with their gender identity. SRS is a crucial aspect of gender transition for many transgender individuals. The specific procedures involved in SRS can vary based on the direction of transition, whether male-to-female (MTF) or female-to-male (FTM). Here are details on sex reassignment surgery for both MTF and FTM individuals:

Male-to-Female (MTF) Sex Reassignment Surgery:

1. Vaginoplasty:
   • Description: The primary surgery for MTF individuals, vaginoplasty involves the construction of a neovagina using penile and scrotal tissues.
   • Techniques: The penile inversion method is common, where the penile skin is used to create the vaginal canal.
2. Orchiectomy:
   • Description: Removal of the testicles to reduce testosterone production, often performed as a preliminary step or concurrently with vaginoplasty.
3. Clitoroplasty:
   • Description: Construction of a clitoris using penile or other available tissue for improved external aesthetics.
4. Labiaplasty:
   • Description: Shaping the labia using scrotal or penile tissue to enhance the overall appearance.
5. Urethral Lengthening:
   • Description: Repositioning the urethra for a more natural location, allowing for a standing urination position.

Female-to-Male (FTM) Sex Reassignment Surgery:

1. Chest Reconstruction (Top Surgery):
   • Description: Removal of breast tissue to create a more masculine chest contour.
   • Techniques: Double incision with nipple grafts or periareolar incision are common methods.
2. Hysterectomy and Oophorectomy:
   • Description: Removal of the uterus and ovaries to eliminate menstrual cycles and reduce estrogen production.
3. Phalloplasty:
   • Description: A complex procedure creating a neophallus using skin grafts, often from the forearm or thigh.
   • Options: Different types include radial forearm flap, anterolateral thigh flap, and others.
4. Metoidioplasty:
   • Description: This procedure releases the clitoris to increase its size, creating a structure that resembles a small penis.
5. Scrotoplasty:
   • Description: Construction of a scrotum using labial tissue to house testicular implants.

Considerations for Both MTF and FTM:

1. Glansplasty:
   • Description: Construction of a glans for MTF individuals during vaginoplasty and for FTM individuals during phalloplasty.
2. Hair Removal:
   • Description: Preoperative hair removal procedures (electrolysis or laser) may be recommended for specific surgeries.

Postoperative Care and Recovery:

1. Dilation Exercises:
   • Purpose: Ensures the depth and width of the neovagina or neophallus.
   • Frequency: Regular dilation exercises are crucial during the recovery period.
2. Follow-Up Appointments:
   • Importance: Regular check-ups with healthcare professionals are necessary to monitor healing and address any complications.
3. Psychosocial Support:
   • Importance: Emotional and psychological support is essential, and individuals may benefit from counseling or support groups.

Risks and Considerations:

1. Infection and Bleeding:
   • Risks: As with any surgery, there is a risk of infection and bleeding.
2. Urethral Complications:
   • Consideration: Urethral complications may occur, necessitating careful surgical technique.
3. Psychological Well-being:
   • Importance: Emotional well-being is a crucial consideration, and pre- and postoperative mental health support is often recommended.

It’s important for individuals considering sex reassignment surgery to consult with experienced healthcare professionals specializing in transgender care. Comprehensive preoperative evaluation, informed decision-making, and ongoing support are critical components of the overall care process. Access to gender-affirming care may vary, and each individual’s journey is unique.

 

Feminizing genital surgery

“Feminizing genital surgery” typically refers to gender confirmation surgeries performed on transgender women (male-to-female individuals) to create female genitalia. The primary procedure associated with feminizing genital surgery is vaginoplasty. Here are details on the surgery:

Vaginoplasty:

1. Penile Inversion Technique:

1. • Description: The most common technique involves using penile and scrotal tissues to create the neovagina.
   • Procedure: The penis is inverted to form the vaginal canal, and the scrotal tissue is often used to construct the labia.

2. Urethral Repositioning:

1. • Description: The urethra is repositioned to a more natural location within the neovagina.
   • Purpose: Aims to allow for a more natural appearance and function.

3. Orchiectomy:

1. • Description: Removal of the testicles is often performed in conjunction with vaginoplasty to reduce testosterone production.

4. Clitoroplasty:

1. • Description: Construction of a clitoris using penile or other available tissue for improved external aesthetics.

5. Labia Construction:

1. • Description: Shaping the labia majora and minora using scrotal and penile tissues for a more feminine appearance.

Preoperative Considerations:

1. Hormone Therapy:

1. • Role: Many transgender women undergo hormone therapy before surgery to promote physical and emotional changes.
   • Impact: Hormones help soften skin, redistribute body fat, and reduce body hair.

2. Psychological Evaluation:

1. • Requirement: A psychological evaluation is often part of the preoperative process to ensure mental readiness for the surgery.

Postoperative Care:

1. Dilation Exercises:

1. • Purpose: Regular dilation exercises are crucial to maintaining the depth and width of the neovagina.
   • Frequency: Dilation schedules vary but are typically performed several times a day initially, gradually reducing over time.

2. Recovery Period:

1. • Duration: The recovery period varies, but patients often need several weeks to heal.
   • Activity Restrictions: Physical activity may be restricted during the initial recovery phase.

3. Follow-Up Appointments:

1. • Importance: Regular follow-up appointments with healthcare professionals are necessary to monitor healing and address any complications.

4. Psychosocial Support:

1. • Importance: Emotional and psychological support is crucial. Patients may benefit from counseling or support groups.

Risks and Considerations:

1. Infection and Bleeding:

1. • Risks: As with any surgery, there is a risk of infection and bleeding.

2. Neovaginal Stenosis:

1. • Description: This refers to the narrowing of the neovaginal canal and may require intervention or additional dilation.

3. Sensation Changes:

1. • Consideration: Changes in sensation, particularly in the genital area, may occur.

It’s crucial for individuals considering feminizing genital surgery to consult with experienced healthcare professionals specializing in transgender care. Comprehensive preoperative evaluations, informed decision-making, and ongoing support are essential components of the overall care process. Access to gender-affirming care may vary, and the decision to undergo surgery is highly personal.

 

MtF bottom surgery

Male-to-female (MtF) bottom surgery, also known as gender confirmation surgery for transgender women, typically involves procedures to create female genitalia. The primary surgery associated with MtF bottom surgery is vaginoplasty. Here are details on the surgery:

Vaginoplasty:

1. Penile Inversion Technique:

1. • Description: The most common technique involves using penile and scrotal tissues to create the neovagina.
   • Procedure: The penis is inverted to form the vaginal canal, and the scrotal tissue is often used to construct the labia.

2. Urethral Repositioning:

1. • Description: The urethra is repositioned to a more natural location within the neovagina.
   • Purpose: Aims to allow for a more natural appearance and function.

3. Orchiectomy:

1. • Description: Removal of the testicles is often performed in conjunction with vaginoplasty to reduce testosterone production.

4. Clitoroplasty:

1. • Description: Construction of a clitoris using penile or other available tissue for improved external aesthetics.

5. Labia Construction:

1. • Description: Shaping the labia majora and minora using scrotal and penile tissues for a more feminine appearance.

Preoperative Considerations:

1. Hormone Therapy:

1. • Role: Many transgender women undergo hormone therapy before surgery to promote physical and emotional changes.
   • Impact: Hormones help soften skin, redistribute body fat, and reduce body hair.

2. Psychological Evaluation:

1. • Requirement: A psychological evaluation is often part of the preoperative process to ensure mental readiness for the surgery.

Postoperative Care:

1. Dilation Exercises:

1. • Purpose: Regular dilation exercises are crucial to maintaining the depth and width of the neovagina.
   • Frequency: Dilation schedules vary but are typically performed several times a day initially, gradually reducing over time.

2. Recovery Period:

1. • Duration: The recovery period varies, but patients often need several weeks to heal.
   • Activity Restrictions: Physical activity may be restricted during the initial recovery phase.

3. Follow-Up Appointments:

1. • Importance: Regular follow-up appointments with healthcare professionals are necessary to monitor healing and address any complications.

4. Psychosocial Support:

1. • Importance: Emotional and psychological support is crucial. Patients may benefit from counseling or support groups.

Risks and Considerations:

1. Infection and Bleeding:

1. • Risks: As with any surgery, there is a risk of infection and bleeding.

2. Neovaginal Stenosis:

1. • Description: This refers to the narrowing of the neovaginal canal and may require intervention or additional dilation.

3. Sensation Changes:

1. • Consideration: Changes in sensation, particularly in the genital area, may occur.

It’s crucial for individuals considering MtF bottom surgery to consult with experienced healthcare professionals specializing in transgender care. Comprehensive preoperative evaluations, informed decision-making, and ongoing support are essential components of the overall care process. Access to gender-affirming care may vary, and the decision to undergo surgery is highly personal.

 

Gender-affirming vaginoplasty

Gender-affirming vaginoplasty, also known as male-to-female (MTF) vaginoplasty or MtF genital reconstruction surgery, is a significant aspect of gender confirmation surgery for transgender women. This procedure involves the construction of a neovagina, aligning the physical characteristics with the individual’s gender identity. Here are detailed aspects of gender-affirming vaginoplasty:

Surgical Techniques:

1. Penile Inversion Technique:
   • Description: The most common method involves using penile and scrotal tissues to create the neovagina.
   • Procedure: The penis is inverted to form the vaginal canal, and the scrotal tissue is often utilized for labia construction.
2. Non-Penile Inversion Techniques:
   • Description: Some surgeons may use alternative grafts, such as intestinal or peritoneal tissue, to create the neovagina.

Surgical Steps:

1. Orchiectomy:
   • Description: Removal of the testicles is often performed to reduce testosterone production.
   • Timing: Orchiectomy may be done as a standalone procedure or concurrently with vaginoplasty.
2. Vaginal Canal Construction:
   • Description: Creating the vaginal canal involves meticulous shaping and suturing of penile and scrotal tissues.
   • Depth: The surgeon aims to achieve a sufficient depth for functional and aesthetic purposes.
3. Clitoroplasty:
   • Description: Construction of a clitoris using penile or other available tissue to enhance external aesthetics.
4. Labia Construction:
   • Description: Shaping the labia majora and minora using scrotal and penile tissues for a more feminine appearance.
5. Urethral Repositioning:
   • Description: Repositioning the urethra to a more natural location within the neovagina.

Preoperative Considerations:

1. Hormone Therapy:
   • Role: Many transgender women undergo hormone therapy before surgery to promote physical and emotional changes.
   • Impact: Hormones help soften skin, redistribute body fat, and reduce body hair.
2. Psychological Evaluation:
   • Requirement: A psychological evaluation is often part of the preoperative process to ensure mental readiness for the surgery.

Postoperative Care:

1. Dilation Exercises:
   • Purpose: Regular dilation exercises are crucial to maintaining the depth and width of the neovagina.
   • Frequency: Dilation schedules vary but are typically performed several times a day initially, gradually reducing over time.
2. Recovery Period:
   • Duration: The recovery period varies, but patients often need several weeks to heal.
   • Activity Restrictions: Physical activity may be restricted during the initial recovery phase.
3. Follow-Up Appointments:
   • Importance: Regular follow-up appointments with healthcare professionals are necessary to monitor healing and address any complications.
4. Psychosocial Support:
   • Importance: Emotional and psychological support is crucial. Patients may benefit from counseling or support groups.

Risks and Considerations:

1. Infection and Bleeding:
   • Risks: As with any surgery, there is a risk of infection and bleeding.
2. Neovaginal Stenosis:
   • Description: This refers to the narrowing of the neovaginal canal and may require intervention or additional dilation.
3. Sensation Changes:
   • Consideration: Changes in sensation, particularly in the genital area, may occur.

It’s important for individuals considering gender-affirming vaginoplasty to consult with experienced healthcare professionals specializing in transgender care. Comprehensive preoperative evaluations, informed decision-making, and ongoing support are essential components of the overall care process. Access to gender-affirming care may vary, and the decision to undergo surgery is highly personal.