There are two main types of bottom surgery for transgender men (FTM): metoidioplasty and phalloplasty.
⦁ Metoidioplasty is a procedure that uses the existing clitoral tissue to create a larger, more visible phallus. The clitoris is typically lengthened and the urethra is repositioned to allow standing urination. Scrotal implants may also be added to create the appearance of testicles. Metoidioplasty is typically a one-stage procedure that can be performed in a hospital or outpatient surgery center.
⦁ Phalloplasty is a more complex procedure that uses tissue from another part of the body, such as the arm or thigh, to create a penis. The urethra is also repositioned and the penis may be implanted with erectile tissue or a prosthesis. Phalloplasty is typically a two-stage procedure that can take several months to complete.
Both metoidioplasty and phalloplasty can be life-changing procedures for transgender men. However, it is important to weigh the risks and benefits of each procedure carefully before making a decision. Some factors to consider include the cost of surgery, the recovery time, and the desired outcome.

Here are some additional resources that you may find helpful:
⦁ The World Professional Association for Transgender Health (WPATH):
⦁ The American Society of Plastic Surgeons (ASPS):
⦁ The Human Rights Campaign:

There are several types of bottom surgery (also known as genital reconstruction surgery or gender confirmation surgery) available for transgender men (female to male). Here are some of the common types:
⦁ Metoidioplasty: Metoidioplasty involves releasing the clitoris from the surrounding tissue to create a small phallus. This procedure works best for individuals who have undergone hormone therapy and have experienced significant clitoral growth. The urethra can be lengthened to allow for standing urination, and scrotoplasty can be performed to create a scrotum.
⦁ Phalloplasty: Phalloplasty involves constructing a neophallus using tissue grafts, typically from the forearm or thigh. The neophallus is then surgically connected to the existing genital area. Phalloplasty may require multiple stages, and additional procedures like urethral lengthening and erectile prostheses can be performed to enhance functionality.
⦁ Radial Forearm Flap Phalloplasty: This technique uses skin and tissue from the forearm to create the neophallus. The tissue is harvested along with the radial artery, which allows for the formation of an erectile implant later in the process.
⦁ Alternative Flap Phalloplasty: In addition to the radial forearm flap, other flap options like the anterolateral thigh (ALT) flap or the pedicled groin flap can be used to create the neophallus.
⦁ Centurion Procedure: The Centurion procedure is a variation of the metoidioplasty where the clitoral hood is used to form the neophallus. This technique allows for the preservation of the clitoral sensory nerves.

It’s important to note that not all transgender men pursue bottom surgery, and the decision to undergo any type of surgical intervention is a personal one that should be made after thorough consultation with a qualified gender-affirming surgeon. Each individual’s anatomy, goals, and medical history may impact the suitability and outcomes of different surgical options. Consulting with a healthcare professional experienced in transgender healthcare is essential to determine the most appropriate surgical approach for your specific needs.