Transfeminine bottom surgery, also known as male-to-female (MTF) gender confirmation surgery or vaginoplasty, involves creating a neovagina, labia, and clitoris. The surgery aims to provide both aesthetic and functional results.

Aesthetic Results: The goal of transfeminine bottom surgery is to create genitals that closely resemble cisgender female genitals in appearance. This includes a neovagina, a clitoris created usually from the glans of the penis to preserve sensation, and labia made from scrotal skin. Surgeons will typically work to place incisions strategically to minimize visible scarring.

Functional Results: A successful vaginoplasty also has functional results:

  1. The neovagina is typically capable of sexual penetration.
  2. The neoclitoris, which is often formed from the glans or head of the penis, is typically capable of sexual sensation and orgasm.
  3. While neovaginal secretions can occur, many transgender women find they need to use additional lubrication for comfortable sexual intercourse.
  4. The neovagina does not connect to the uterus (as transgender women do not have a uterus) and therefore menstruation and childbirth are not possible.
  5. The surgery also typically involves a shortening and repositioning of the urethra to allow urination in a sitting position.

The specific results of surgery can vary widely depending on individual factors and the surgeon’s technique. Satisfaction rates with MTF bottom surgery are generally high, but like all surgical procedures, there are potential risks and complications, including loss of sensation, complications related to dilation, and need for revision surgeries.

It’s crucial for anyone considering this surgery to have detailed discussions with their healthcare providers, ideally including a surgeon experienced in gender confirmation surgeries, to fully understand the procedure, potential risks, expected outcomes, and aftercare requirements.