Metoidioplasty, also known as metaoidioplasty or metaidoioplasty, is a type of gender-affirming surgery that is performed on transgender men. The goal of metoidioplasty is to create a penis from the existing genital tissue.

Metoidioplasty is a less-extensive procedure than phalloplasty, which is another type of gender-affirming surgery for transgender men. In metoidioplasty, the surgeon releases the clitoris from the surrounding tissue and exposes it. The surgeon may also lengthen the clitoris by releasing the suspensory ligament. In some cases, the surgeon may also create a scrotum by using tissue from the labia.

The results of metoidioplasty can vary depending on the individual’s anatomy and the surgeon’s technique. However, most people who have metoidioplasty are able to achieve a penis that is about 1-2 inches long. The penis may also be able to become erect, but it will not be as large or as firm as a penis that is created through phalloplasty.

Metoidioplasty is typically performed under general anesthesia and takes about 2-3 hours. The recovery time for metoidioplasty is typically 4-6 weeks. During this time, the incisions will need to be cared for and the patient will need to wear a compression garment. There may be some pain and discomfort, but most patients are able to return to work and other activities within a few weeks.

Metoidioplasty is a safe and effective procedure for transgender men. However, as with any surgery, there are some risks associated with metoidioplasty. These risks include infection, bleeding, and complications from anesthesia.

If you are considering metoidioplasty, it is important to talk to a surgeon about the risks and benefits of the procedure. The surgeon will be able to assess your eligibility for surgery and help you make the best decision for yourself.

Here are some additional resources that you may find helpful:

  • The World Professional Association for Transgender Health (WPATH) website: https://www.wpath.org/
  • The American Society of Plastic Surgeons (ASPS) website: https://www.plasticsurgery.org/
  • The Trevor Project: https://www.thetrevorproject.org/

Metoidioplasty is a gender-affirming surgical procedure performed on individuals assigned female at birth who identify as male or non-binary and wish to align their physical appearance with their gender identity. It is one of the options available for bottom surgery in female-to-male (FTM) or transmasculine individuals.

Metoidioplasty involves several surgical techniques that aim to create a neophallus using the existing clitoral tissue, which has been hormonally enlarged through testosterone therapy. The clitoral tissue is released from the surrounding structures to allow for increased length and improved projection. The procedure can also involve urethral lengthening to allow for standing urination, scrotoplasty to create a scrotum, and sometimes vaginectomy to remove the vaginal canal.

It’s important to note that metoidioplasty results in a smaller-sized phallus compared to phalloplasty. The size and functionality of the neophallus will depend on several factors, including the individual’s hormonal changes, pre-existing anatomy, and surgical technique used.

As with any surgical procedure, it is essential to consult with a qualified and experienced surgeon who specializes in transgender surgeries to discuss your individual goals, expectations, and any potential risks or complications. They will be able to provide personalized advice based on your unique circumstances and help you determine if metoidioplasty is the right choice for you.

Metoidioplasty

Metoidioplasty is a gender-affirming surgical procedure designed for transgender individuals who were assigned female at birth (AFAB) and have undergone testosterone therapy to induce masculinizing changes, including clitoral enlargement. The primary goal of metoidioplasty is to create a neophallus, which is a structure resembling a penis, using the hormonally enlarged clitoris. Here are more detailed aspects of metoidioplasty:

**1. Surgical Techniques:

  • Clitoral Release: The procedure typically begins with clitoral release, separating the clitoris from the surrounding tissue to make it more visible.
  • Urethral Lengthening: In some cases, urethral lengthening may be performed to allow for standing urination. This involves extending the urethra through the neophallus.
  • Scrotoplasty: Scrotoplasty may be part of metoidioplasty, where the labia majora are used to create a scrotum-like structure. Testicular implants may be placed within the scrotum for a more natural appearance.
  • Vaginectomy: Vaginectomy, or removal of the vaginal canal, is an optional step in metoidioplasty.

**2. Hormonal Requirements:

  • Testosterone Therapy: Metoidioplasty is typically performed on individuals who have undergone testosterone therapy to induce clitoral growth and other masculinizing effects.
  • Clitoral Enlargement: The hormonal effects of testosterone lead to significant enlargement of the clitoris, providing tissue for the construction of the neophallus.

**3. Stages and Multiple Surgeries:

  • Phased Approach: Metoidioplasty is often performed in multiple stages, addressing different aspects of the procedure in each phase.
  • Healing Time: There is a period of healing and recovery between stages to allow for proper tissue healing.

**4. Urethral Lengthening:

  • Functional Aspect: Urethral lengthening is often included to enhance the functional aspects of the neophallus, enabling standing urination.
  • Complexity: Urethral lengthening adds complexity to the procedure and may be performed in a separate stage.

**5. Scrotoplasty:

  • Creation of Scrotum: Scrotoplasty involves the creation of a scrotum-like structure using the labia majora.
  • Testicular Implants: Testicular implants can be placed within the scrotum for a more anatomically masculine appearance.

**6. Vaginectomy:

  • Optional Procedure: Vaginectomy is an optional component of metoidioplasty and involves the removal of the vaginal canal.
  • Closure of Vaginal Opening: Closing the vaginal opening is part of vaginectomy.

**7. Results and Sensation:

  • Neophallus Appearance: The appearance of the neophallus is individualized and depends on factors such as hormonal response, tissue availability, and surgical techniques.
  • Sensation: Sensation in the neophallus varies among individuals, and some may experience erotic sensation.

**8. Erectile Function:

  • Erectile Potential: Metoidioplasty allows for the potential of erectile function due to the natural erectile capabilities of the hormonally enlarged clitoris.
  • Erectile Prosthesis: Some individuals may opt for an erectile prosthesis to enhance rigidity during sexual activity.

**9. Postoperative Care:

  • Recovery Period: After metoidioplasty, individuals undergo a recovery period, and postoperative care includes monitoring for complications and following the surgeon’s instructions.
  • Potential Complications: Complications may include issues such as infection, hematoma, or delayed healing.

**10. Considerations and Eligibility: – Individualized Decision: Deciding on metoidioplasty is a personal choice, and individuals should carefully consider their goals, expectations, and the potential outcomes. – Eligibility Criteria: Eligibility for metoidioplasty is determined by factors such as overall health, hormonal status, and psychological readiness.

Metoidioplasty is one of the gender-affirming surgical options available to transgender individuals, and the decision to undergo the procedure is based on individual preferences, goals, and medical considerations. As with any medical intervention, thorough discussions with experienced gender-affirming surgeons, consideration of potential outcomes, and careful evaluation of eligibility criteria are crucial steps in the decision-making process.

Gender-affirming surgery

Gender-affirming surgery refers to a range of surgical procedures designed to help transgender individuals achieve a physical appearance that aligns with their gender identity. These surgeries are often an important component of a person’s gender transition, providing a means to address dysphoria and enhance well-being. The specific surgeries chosen depend on an individual’s gender identity, goals, and medical considerations. Here are key details about gender-affirming surgery:

**1. Purpose:

  • Gender Congruence: The primary goal of gender-affirming surgery is to align an individual’s physical characteristics with their affirmed gender identity.
  • Dysphoria Alleviation: These surgeries aim to alleviate gender dysphoria, the distress or discomfort that may arise from incongruence between one’s gender identity and assigned sex at birth.

**2. Types of Gender-Affirming Surgeries:

  • Top Surgery: Involves chest reconstruction and is often chosen by transgender individuals to masculinize or feminize their chest, depending on their affirmed gender.
  • Bottom Surgery: Encompasses various procedures for genital reconstruction, including vaginoplasty (feminizing), phalloplasty (masculinizing), metoidioplasty, and more.
  • Facial Feminization Surgery (FFS): Focuses on altering facial features to achieve a more feminine appearance, often chosen by transgender women.
  • Facial Masculinization Surgery (FMS): Similar to FFS but focuses on masculinizing facial features, often chosen by transgender men.
  • Tracheal Shave: A procedure to reduce the prominence of the Adam’s apple.
  • Voice Surgery: Surgical procedures to modify vocal characteristics, including pitch and resonance.

**3. Eligibility and Assessment:

  • Comprehensive Evaluation: Individuals typically undergo a thorough assessment, including medical, psychological, and sometimes hormonal evaluations, to determine eligibility for surgery.
  • Informed Consent: Some surgeries follow an informed consent model, where individuals provide informed consent after understanding the risks, benefits, and potential outcomes.

**4. Hormonal Therapy:

  • Preparation for Surgery: Many individuals undergo hormone replacement therapy (HRT) before or in conjunction with gender-affirming surgery to induce secondary sex characteristics consistent with their gender identity.

**5. Surgical Phases and Staging:

  • Multiple Stages: Some surgeries are performed in multiple stages to achieve the desired outcomes gradually.
  • Healing Time: There are periods of healing and recovery between surgical stages.

**6. Postoperative Care:

  • Recovery Period: After surgery, individuals require a period of recovery, during which they follow specific postoperative care instructions.
  • Monitoring for Complications: Healthcare providers monitor for potential complications, and individuals may need follow-up appointments.

**7. Sensation and Functionality:

  • Variable Outcomes: Outcomes regarding sensation and functionality vary among individuals and specific surgeries.
  • Erectile Function: Some surgeries, such as phalloplasty, may include procedures to enable erectile function.

**8. Legal and Identity Documents:

  • Updating Gender Markers: Many individuals opt to update their gender markers on identification documents, such as driver’s licenses and passports, to reflect their affirmed gender post-surgery.
  • Name Change: Some individuals also undergo legal name changes to align with their affirmed gender.

**9. Psychosocial Support:

  • Mental Health Considerations: Gender-affirming surgeries often involve psychological and emotional aspects, and individuals may benefit from mental health support before, during, and after the procedures.
  • Supportive Networks: Connecting with support groups or individuals who have undergone similar surgeries can provide valuable emotional support.

**10. Ongoing Medical Care: – Long-Term Follow-Up: Individuals who undergo gender-affirming surgery may require ongoing medical care and follow-up appointments to monitor health and address any issues that may arise.

Gender-affirming surgery is a deeply personal decision, and individuals considering these procedures should work closely with experienced healthcare professionals who specialize in transgender healthcare. Open communication with healthcare providers, thorough research, and a supportive network can contribute to a positive experience throughout the gender-affirming surgical journey.

 

Clitoral release

Clitoral release, also known as clitoral advancement or clitoral hood reduction, is a surgical procedure often performed as part of metoidioplasty, a gender-affirming surgery for transgender individuals assigned female at birth (AFAB). This procedure is specifically designed to enhance the visibility and exposure of the hormonally enlarged clitoris, which has undergone growth due to testosterone therapy. Here are key details about clitoral release:

  1. Purpose:
  • Visibility: The primary goal of clitoral release is to make the hormonally enlarged clitoris more visible by reducing the surrounding tissue known as the clitoral hood.
  • Aesthetic Outcome: The procedure aims to create a more exposed and prominent appearance of the clitoris, resembling the glans of the penis.
  1. Inclusion in Metoidioplasty:
  • Part of Metoidioplasty: Clitoral release is often one of the initial stages in metoidioplasty, a series of surgical procedures aimed at creating a neophallus using the hormonally enlarged clitoris.
  1. Surgical Technique:
  • Incision: The surgeon makes incisions in the clitoral hood, carefully removing excess tissue.
  • Hood Reduction: The primary focus is on reducing the size of the clitoral hood to expose the enlarged clitoris.
  • Preservation of Sensation: Surgeons aim to preserve nerve function and sensitivity during the procedure to maintain erotic sensation.
  1. Potential Stages:
  • Multistage Approach: In some cases, clitoral release may be performed as a standalone procedure or in conjunction with other stages of metoidioplasty.
  • Multiple Surgeries: Metoidioplasty, including clitoral release, is often performed in multiple stages with healing periods between surgeries.
  1. Urethral Lengthening:
  • Optional Inclusion: Clitoral release may be combined with urethral lengthening in metoidioplasty for individuals seeking additional functional changes, such as standing urination.
  1. Postoperative Care:
  • Recovery Period: After clitoral release, individuals undergo a recovery period during which they follow specific postoperative care instructions.
  • Monitoring: Healthcare providers monitor for any signs of complications, and individuals may have follow-up appointments to assess healing.
  1. Sensation and Functionality:
  • Preservation of Sensation: Surgeons aim to preserve the nerve supply to the clitoris during clitoral release to maintain erotic sensation.
  • Individual Variation: Outcomes in terms of sensation and functionality can vary among individuals.
  1. Eligibility and Decision-Making:
  • Individual Choice: Deciding to undergo clitoral release or metoidioplasty is a personal choice, and individuals should carefully consider their goals, expectations, and potential outcomes.
  • Eligibility Criteria: Eligibility for clitoral release is determined based on factors such as overall health, hormonal status, and psychological readiness.
  1. Psychosocial Support:
  • Emotional Aspects: Gender-affirming surgeries, including clitoral release, can have emotional and psychological aspects. Individuals may benefit from mental health support before, during, and after the procedure.
  • Supportive Networks: Connecting with support groups or individuals who have undergone similar surgeries can provide valuable emotional support.
  1. Follow-Up Procedures: – Continued Surgical Steps: For those pursuing metoidioplasty, clitoral release is often followed by additional surgical steps, such as urethral lengthening, scrotoplasty, or vaginectomy, depending on individual goals and preferences.

As with any gender-affirming surgery, individuals considering clitoral release should work closely with experienced healthcare professionals who specialize in transgender healthcare. Open communication with healthcare providers, thorough research, and support from a knowledgeable and understanding healthcare team can contribute to a positive experience throughout the surgical journey.

 

Urethral lengthening

Urethral lengthening is a surgical procedure commonly performed as part of gender-affirming surgeries for transgender individuals undergoing metoidioplasty or phalloplasty. The procedure involves extending the urethra to allow for standing urination, contributing to a more masculinized appearance. Here are key details about urethral lengthening:

  1. Purpose:
  • Functional Aspect: The primary goal of urethral lengthening is to create a neophallus with a urethra that extends to the tip, allowing individuals to urinate in a standing position.
  • Enhanced Masculinization: Urethral lengthening is often chosen by transgender men as part of the masculinization process during metoidioplasty or phalloplasty.
  1. Inclusion in Metoidioplasty and Phalloplasty:
  • Metoidioplasty: Urethral lengthening can be part of metoidioplasty, which involves creating a neophallus using the hormonally enlarged clitoris.
  • Phalloplasty: Urethral lengthening is also a component of phalloplasty, a procedure that involves constructing a neophallus using tissue grafts from various donor sites.
  1. Surgical Techniques:
  • Tissue Grafts: The surgeon uses tissue grafts to extend the urethra within the neophallus.
  • Microvascular Techniques: In phalloplasty, microvascular techniques may be employed to connect blood vessels, ensuring proper blood supply to the neophallus.
  1. Stages of Surgery:
  • Multistage Approach: Urethral lengthening is often performed as one stage in a multistage process, and there may be multiple surgeries to achieve the desired outcomes.
  • Healing Time: There are periods of healing between surgical stages to allow for proper recovery.
  1. Postoperative Care:
  • Recovery Period: After urethral lengthening, individuals undergo a recovery period during which they follow specific postoperative care instructions.
  • Monitoring: Healthcare providers monitor for any signs of complications, and individuals may have follow-up appointments to assess healing and address any issues.
  1. Sensation and Functionality:
  • Preservation of Sensation: Surgeons aim to preserve nerve supply during urethral lengthening to maintain sensation in the neophallus.
  • Functional Outcomes: The procedure aims to achieve functional outcomes, allowing for natural urination in a standing position.
  1. Complications and Risks:
  • Potential Complications: Complications can include issues such as infection, fistula formation (abnormal connection between the urethra and surrounding structures), or strictures (narrowing of the urethra).
  • Risk Mitigation: Surgeons take measures to minimize the risk of complications, and individuals are monitored closely during the postoperative period.
  1. Individual Variation:
  • Outcome Variability: Outcomes of urethral lengthening can vary among individuals based on factors such as tissue quality, surgical technique, and individual healing responses.
  • Expectation Management: Surgeons work closely with individuals to manage expectations and provide realistic perspectives on outcomes.
  1. Eligibility and Decision-Making:
  • Personal Choice: Deciding to undergo urethral lengthening is a personal choice, and individuals should carefully consider their goals, expectations, and potential outcomes.
  • Eligibility Criteria: Eligibility for urethral lengthening is determined based on factors such as overall health, hormonal status, and psychological readiness.
  1. Psychosocial Support: – Emotional Aspects: Gender-affirming surgeries, including urethral lengthening, can have emotional and psychological aspects. Individuals may benefit from mental health support before, during, and after the procedure. – Supportive Networks: Connecting with support groups or individuals who have undergone similar surgeries can provide valuable emotional support.

As with any gender-affirming surgery, individuals considering urethral lengthening should work closely with experienced healthcare professionals specializing in transgender healthcare. Open communication with healthcare providers, thorough research, and support from a knowledgeable healthcare team can contribute to a positive experience throughout the surgical journey.

 

Scrotoplasty

Scrotoplasty is a surgical procedure that involves the creation of a scrotum or scrotal sac. This procedure is often performed as part of gender-affirming surgeries for transgender individuals undergoing genital reconstruction. Scrotoplasty is typically chosen by individuals who are seeking a more masculinized appearance and may be part of metoidioplasty or phalloplasty. Here are key details about scrotoplasty:

  1. Purpose:
  • Masculinization: The primary goal of scrotoplasty is to create a scrotum, contributing to a more anatomically masculine appearance.
  • Housing Testicular Implants: Scrotoplasty provides a pouch-like structure that can house testicular implants, enhancing the external appearance of the genital region.
  1. Inclusion in Metoidioplasty and Phalloplasty:
  • Metoidioplasty: Scrotoplasty is often performed as part of metoidioplasty, which involves creating a neophallus using the hormonally enlarged clitoris.
  • Phalloplasty: Scrotoplasty is also a component of phalloplasty, a procedure that involves constructing a neophallus using tissue grafts from various donor sites.
  1. Surgical Techniques:
  • Tissue Grafts: The surgeon may use tissue grafts from the labia majora or other sources to create the scrotal sac.
  • Implant Placement: In scrotoplasty, the scrotal sac is designed to accommodate testicular implants, providing a more natural appearance.
  1. Stages of Surgery:
  • Multistage Approach: Scrotoplasty is often performed as one stage in a multistage process, and there may be multiple surgeries to achieve the desired outcomes.
  • Healing Time: There are periods of healing between surgical stages to allow for proper recovery.
  1. Testicular Implants:
  • Optional Inclusion: While scrotoplasty provides the anatomical structure of a scrotum, individuals may choose to include testicular implants for a more complete appearance.
  • Size and Shape Options: Testicular implants come in various sizes and shapes, and individuals can discuss their preferences with the surgeon.
  1. Postoperative Care:
  • Recovery Period: After scrotoplasty, individuals undergo a recovery period during which they follow specific postoperative care instructions.
  • Monitoring: Healthcare providers monitor for any signs of complications, and individuals may have follow-up appointments to assess healing and address any issues.
  1. Complications and Risks:
  • Potential Complications: Complications can include issues such as infection, delayed wound healing, or issues related to implant placement.
  • Risk Mitigation: Surgeons take measures to minimize the risk of complications, and individuals are monitored closely during the postoperative period.
  1. Individual Variation:
  • Outcome Variability: Outcomes of scrotoplasty can vary among individuals based on factors such as tissue quality, surgical technique, and individual healing responses.
  • Expectation Management: Surgeons work closely with individuals to manage expectations and provide realistic perspectives on outcomes.
  1. Eligibility and Decision-Making:
  • Personal Choice: Deciding to undergo scrotoplasty is a personal choice, and individuals should carefully consider their goals, expectations, and potential outcomes.
  • Eligibility Criteria: Eligibility for scrotoplasty is determined based on factors such as overall health, hormonal status, and psychological readiness.
  1. Psychosocial Support: – Emotional Aspects: Gender-affirming surgeries, including scrotoplasty, can have emotional and psychological aspects. Individuals may benefit from mental health support before, during, and after the procedure. – Supportive Networks: Connecting with support groups or individuals who have undergone similar surgeries can provide valuable emotional support.

As with any gender-affirming surgery, individuals considering scrotoplasty should work closely with experienced healthcare professionals specializing in transgender healthcare. Open communication with healthcare providers, thorough research, and support from a knowledgeable healthcare team can contribute to a positive experience throughout the surgical journey.

 

Testosterone therapy

Testosterone therapy, also known as hormone replacement therapy (HRT) for transgender men or individuals assigned female at birth (AFAB) seeking masculinization, involves the administration of testosterone to induce and maintain masculine secondary sex characteristics. Testosterone is the primary male sex hormone responsible for the development of traits such as increased muscle mass, facial hair growth, deepening of the voice, and more. Here are key details about testosterone therapy:

**1. Purpose:

  • Masculinization: The primary goal of testosterone therapy is to induce the development of masculine secondary sex characteristics in transgender men.
  • Alleviation of Gender Dysphoria: Testosterone therapy can help alleviate gender dysphoria by aligning physical traits with an individual’s gender identity.

**2. Administration Methods:

  • Intramuscular Injections: Testosterone is often administered via intramuscular injections into the thigh or buttocks. Injection frequency may vary depending on the specific formulation.
  • Transdermal Patches or Gel: Some individuals use transdermal patches or gel applied to the skin for absorption.
  • Subcutaneous Injections: Subcutaneous injections may be an alternative administration method for some individuals.

**3. Dosage and Monitoring:

  • Individualized Dosages: Dosages are individualized based on factors such as age, overall health, and desired changes. Initial doses may be lower and gradually increased.
  • Regular Monitoring: Regular blood tests are performed to monitor hormone levels, ensuring they are within the desired range.

**4. Changes Induced by Testosterone:

  • Body Composition: Testosterone promotes an increase in muscle mass and a decrease in body fat.
  • Facial and Body Hair Growth: Individuals often experience the growth of facial hair, increased body hair, and potential changes in hair pattern.
  • Voice Deepening: The voice may deepen over time due to the growth of the vocal cords.
  • Clitoral Enlargement: Testosterone can lead to clitoral enlargement in transgender men undergoing hormone therapy.
  • Menstrual Cessation: Menstrual cycles typically stop within a few months of starting testosterone therapy.

**5. Timeline of Changes:

  • Varied Onset: The onset and pace of changes vary among individuals. Some changes, such as increased libido and energy, may occur early, while others, like facial hair growth, may take months or years.
  • Maximum Effects: The full effects of testosterone, including facial hair growth and voice deepening, may take several years to reach their maximum.

**6. Potential Side Effects:

  • Acne: Increased oil production may lead to acne, which can be managed with skincare.
  • Hair Loss: Some individuals may experience hair thinning or male-pattern baldness, especially if there is a genetic predisposition.
  • Mood Changes: Mood swings or changes in mood are possible, and mental health should be closely monitored.
  • Changes in Cholesterol Levels: Testosterone can affect cholesterol levels, and regular monitoring is important.

**7. Fertility Considerations:

  • Impact on Fertility: Testosterone therapy typically leads to infertility, and individuals interested in preserving fertility should explore options such as egg or embryo freezing before starting therapy.
  • Reversible Effects: Some changes induced by testosterone therapy, such as voice deepening and clitoral enlargement, are irreversible.

**8. Pelvic Health:

  • Pelvic Exam: Individuals on testosterone therapy may still need routine gynecological exams, including pelvic exams, to monitor pelvic health.
  • Vaginal Atrophy: Testosterone therapy may lead to vaginal atrophy, and individuals may use moisturizers or low-dose estrogen therapy if needed.

**9. Emotional and Psychological Aspects:

  • Mental Health Monitoring: Testosterone therapy can impact mood, and individuals should be aware of emotional changes. Mental health support is crucial throughout the process.
  • Emotional Well-Being: Positive psychological changes, including increased well-being and confidence, are reported by many individuals.

**10. Long-Term Considerations: – Continued Hormone Therapy: Testosterone therapy is often continued indefinitely to maintain the desired masculine characteristics. – Bone Health: Long-term use of testosterone may require monitoring bone health, as there is some evidence of potential bone density changes.

**11. Legal and Social Implications: – Legal Gender Marker Change: Some individuals pursue legal changes to gender markers on identification documents after undergoing testosterone therapy. – Social Transition:Testosterone therapy may coincide with or be a component of a broader social transition, including changes in name and pronouns.

**12. Comprehensive Care: – Interdisciplinary Approach: Transgender individuals undergoing testosterone therapy often benefit from an interdisciplinary approach involving endocrinologists, mental health professionals, and other healthcare providers. – Informed Consent Model: Some healthcare providers follow an informed consent model, allowing individuals to make informed decisions about hormone therapy after understanding potential risks and benefits.

Testosterone therapy is a significant aspect of gender-affirming care for transgender men. Before starting testosterone therapy, individuals should consult with knowledgeable healthcare providers specializing in transgender healthcare to discuss their goals, expectations, and any potential risks or side effects associated with the treatment. Regular monitoring and ongoing communication with healthcare professionals are crucial throughout the hormone therapy journey.

 

Vaginectomy

Vaginectomy is a surgical procedure involving the removal or closure of the vaginal canal. This gender-affirming surgery is typically chosen by transgender individuals assigned female at birth (AFAB) who are undergoing masculinizing procedures, such as metoidioplasty or phalloplasty. Vaginectomy is performed to align the physical anatomy with the individual’s affirmed gender identity. Here are key details about vaginectomy:

  1. Purpose:
  • Masculinization: Vaginectomy is performed as part of gender-affirming surgeries to contribute to the overall masculinization of the genital region.
  • Creation of Neophallus: Vaginectomy is often associated with metoidioplasty or phalloplasty, where it complements the construction of a neophallus using existing genital tissue.
  1. Inclusion in Metoidioplasty and Phalloplasty:
  • Metoidioplasty: Vaginectomy is often performed as part of metoidioplasty, a procedure that involves creating a neophallus using the hormonally enlarged clitoris.
  • Phalloplasty: Vaginectomy may also be included as part of phalloplasty, a more complex procedure that uses tissue grafts from various donor sites to create a neophallus.
  1. Surgical Techniques:
  • Removal of Vaginal Canal: The surgical process involves the removal or closure of the vaginal canal, preventing its continuation to the external genitalia.
  • Tissue Disposition: Depending on the specific surgical technique, the tissues surrounding the vaginal canal may be repurposed to contribute to the construction of the neophallus.
  1. Stages of Surgery:
  • Multistage Approach: Vaginectomy is often performed as one stage in a multistage process, and there may be multiple surgeries to achieve the desired outcomes.
  • Healing Time: There are periods of healing between surgical stages to allow for proper recovery.
  1. Postoperative Care:
  • Recovery Period: After vaginectomy, individuals undergo a recovery period during which they follow specific postoperative care instructions.
  • Monitoring: Healthcare providers monitor for any signs of complications, and individuals may have follow-up appointments to assess healing and address any issues.
  1. Complications and Risks:
  • Potential Complications: Complications can include issues such as infection, hematoma, delayed wound healing, or issues related to tissue viability.
  • Risk Mitigation: Surgeons take measures to minimize the risk of complications, and individuals are monitored closely during the postoperative period.
  1. Impact on Sexual Function:
  • Affects Vaginal Functionality: Vaginectomy results in the loss of vaginal functionality, and individuals should be aware of the impact on sexual activity.
  • Potential Impact on Libido: The procedure itself does not impact libido, but the changes in genital anatomy may affect individual experiences of pleasure.
  1. Individual Variation:
  • Outcome Variability: Outcomes of vaginectomy can vary among individuals based on factors such as surgical technique, tissue quality, and individual healing responses.
  • Expectation Management: Surgeons work closely with individuals to manage expectations and provide realistic perspectives on outcomes.
  1. Eligibility and Decision-Making:
  • Personal Choice: Deciding to undergo vaginectomy is a personal choice, and individuals should carefully consider their goals, expectations, and potential outcomes.
  • Eligibility Criteria: Eligibility for vaginectomy is determined based on factors such as overall health, hormonal status, and psychological readiness.
  1. Psychosocial Support: – Emotional Aspects: Gender-affirming surgeries, including vaginectomy, can have emotional and psychological aspects. Individuals may benefit from mental health support before, during, and after the procedure. – Supportive Networks: Connecting with support groups or individuals who have undergone similar surgeries can provide valuable emotional support.

As with any gender-affirming surgery, individuals considering vaginectomy should work closely with experienced healthcare professionals specializing in transgender healthcare. Open communication with healthcare providers, thorough research, and support from a knowledgeable healthcare team can contribute to a positive experience throughout the surgical journey.

 

Neophallus

A neophallus refers to a surgically constructed penis, often created through gender-affirming surgeries for transgender men or individuals seeking phalloplasty. The term “neophallus” is used to distinguish the surgically constructed penis from a biological or natal penis. Here are key details about the neophallus:

  1. Purpose:
  • Gender Affirmation: The primary goal of creating a neophallus is to provide individuals with a penis that aligns with their affirmed gender identity, contributing to overall gender affirmation.
  • Masculinization: The construction of a neophallus is often part of gender-affirming surgeries aimed at masculinizing the external genitalia.
  1. Inclusion in Gender-Affirming Surgeries:
  • Phalloplasty: Neophallus creation is a central component of phalloplasty, a gender-affirming surgical procedure that involves constructing a penis using tissue grafts from various donor sites on the body.
  1. Surgical Techniques:
  • Tissue Grafts: Surgeons use tissue grafts, commonly from the forearm, thigh, or other donor sites, to construct the neophallus.
  • Microvascular Techniques: In some cases, microvascular techniques are employed to connect blood vessels, ensuring proper blood supply to the neophallus.
  1. Stages of Surgery:
  • Multistage Approach: Phalloplasty is often performed in multiple stages, with each stage addressing specific aspects of neophallus construction, such as creating the shaft, urethra, and incorporating erectile devices.
  1. Urethral Lengthening:
  • Inclusion in Phalloplasty: Urethral lengthening is often performed in conjunction with phalloplasty to allow individuals to urinate through the neophallus in a standing position.
  1. Erectile Devices:
  • Penile Implants: Some individuals choose to include penile implants, such as inflatable or malleable rods, to achieve erectile function in the neophallus.
  • Erectile Function: The choice of implants depends on individual preferences, and the goal is to provide a neophallus capable of erection for sexual satisfaction.
  1. Postoperative Care:
  • Recovery Period: After neophallus construction, individuals undergo a recovery period during which they follow specific postoperative care instructions.
  • Monitoring: Healthcare providers monitor for any signs of complications, and individuals may have follow-up appointments to assess healing and address any issues.
  1. Complications and Risks:
  • Potential Complications: Complications can include issues such as infection, delayed wound healing, or issues related to tissue viability.
  • Risk Mitigation: Surgeons take measures to minimize the risk of complications, and individuals are monitored closely during the postoperative period.
  1. Sensation and Functionality:
  • Variable Outcomes: Outcomes regarding sensation and functionality of the neophallus can vary among individuals.
  • Preservation of Sensation: Surgeons aim to preserve nerve function during phalloplasty to maintain sensation in the neophallus.
  1. Individual Variation: – Outcome Variability: Outcomes of neophallus construction can vary based on factors such as the choice of donor site, surgical technique, and individual healing responses. – Expectation Management: Surgeons work closely with individuals to manage expectations and provide realistic perspectives on outcomes.
  2. Eligibility and Decision-Making: – Personal Choice: Deciding to undergo neophallus construction is a personal choice, and individuals should carefully consider their goals, expectations, and potential outcomes. – Eligibility Criteria: Eligibility for phalloplasty is determined based on factors such as overall health, hormonal status, and psychological readiness.
  3. Psychosocial Support: – Emotional Aspects: Gender-affirming surgeries, including neophallus construction, can have emotional and psychological aspects. Individuals may benefit from mental health support before, during, and after the procedure. – Supportive Networks: Connecting with support groups or individuals who have undergone similar surgeries can provide valuable emotional support.

Creating a neophallus is a complex and individualized process that involves careful consideration of the patient’s goals, preferences, and overall health. Individuals considering neophallus construction should work closely with experienced healthcare professionals specializing in transgender healthcare. Open communication with healthcare providers, thorough research, and support from a knowledgeable healthcare team can contribute to a positive experience throughout the phalloplasty journey.