Vaginoplasty, also known as gender-affirming genital reconstruction surgery or bottom surgery, is a surgical procedure that some transgender women may choose as part of their transition. It involves the creation of a neovagina, a functional and cosmetically similar structure to the vagina.

Vaginoplasty typically involves several components:

  1. Penile Inversion Technique: The most common technique used in vaginoplasty is the penile inversion technique. It involves using the penile skin to create the lining of the neovagina, while the scrotal skin is used to create the labia. The glans penis is usually repurposed to create a clitoral hood and potentially a clitoris.
  2. Removal of Testes: In most cases, the testes are removed through an orchiectomy (testicle removal) before or during vaginoplasty.
  3. Creation of the Neovagina: The penile skin is inverted to form the inner lining of the neovagina. The surgeon may use grafts or additional tissue to enhance the size and depth of the neovagina.
  4. Placement of the Clitoris: The clitoral hood is created using tissue from the glans penis. The surgeon may also create a clitoris from the glans tissue, but its functionality can vary.
  5. Labiaplasty: The scrotal skin is used to create the labia, giving the neovagina a more natural appearance.

Vaginoplasty is a complex surgical procedure that typically requires specialized training and experience. It carries risks and potential complications, including bleeding, infection, scarring, changes in sensation, and the possibility of unsatisfactory aesthetic or functional outcomes. It’s crucial to consult with experienced surgeons who specialize in transgender healthcare to discuss the specific risks, benefits, and expected outcomes based on individual circumstances.

Before undergoing vaginoplasty, individuals usually need to meet certain criteria, such as living in their desired gender role for a specified period, undergoing hormone replacement therapy (HRT), and receiving mental health evaluations to ensure readiness for surgery.

It’s important to note that vaginoplasty is a major surgical procedure, and recovery can take several weeks to months. Post-operative care, dilation (stretching the neovagina to maintain depth and width), and ongoing follow-up with healthcare providers are necessary for optimal outcomes.

Every individual’s journey is unique, and decisions about gender-affirming surgeries should be made with careful consideration, consultation with healthcare professionals, and access to comprehensive support and resources.