There are a few reasons why someone assigned female at birth might undergo a vaginectomy in FtM surgery.

  • Gender identity: Some transgender men feel that having a vagina is inconsistent with their gender identity. They may feel that the vagina is a reminder of their assigned sex at birth, and they may want to have it removed in order to feel more comfortable in their own skin.
  • Sexuality: Some transgender men may choose to have a vaginectomy in order to have sex in a way that is consistent with their gender identity. For example, they may want to be able to have penetrative sex with a partner.
  • Medical reasons: In some cases, a vaginectomy may be necessary for medical reasons. For example, if a transgender man has a history of vaginal cancer, a vaginectomy may be recommended to prevent the cancer from spreading.

The image you sent me is a picture of a sign that says “Can I have?” This sign could be interpreted in a number of ways. It could be a request for something, such as a piece of candy or a toy. It could also be a statement of identity, such as a transgender man asking for the right to be called by his preferred pronouns.

The sign is also a reminder that gender identity is a complex and personal issue. There is no one right way to be transgender, and each person’s journey is different. If you are considering FtM surgery, it is important to talk to a doctor or therapist who can help you understand your options and make the best decision for you.

Individuals assigned female at birth may choose to undergo a vaginectomy as part of FTM (Female-to-Male) gender-affirming surgery for several reasons, which can vary from person to person. Here are some common reasons:

  1. Gender Identity Alignment: For many transgender men or individuals assigned female at birth, the presence of a vagina can cause significant gender dysphoria, which is the distress or discomfort experienced when one’s gender identity does not align with their assigned sex. A vaginectomy allows them to align their physical body with their male gender identity.
  2. Alleviation of Dysphoria: Some individuals may experience a strong desire to have their external genitalia match their internal sense of self. Removing the vagina can help reduce gender dysphoria and improve their overall well-being and quality of life.
  3. Enhanced Masculinization: Some individuals may opt for a vaginectomy to achieve a more masculine appearance. Removing the vagina, along with other gender-affirming surgeries such as phalloplasty or metoidioplasty, can contribute to the creation of external genitalia that aligns with their gender identity.
  4. Simplifying Hygiene and Care: For some individuals, maintaining vaginal health and hygiene can be challenging and cause discomfort. Removing the vagina can simplify personal care routines and improve overall comfort.

It’s important to note that the decision to undergo a vaginectomy or any other gender-affirming surgery is deeply personal and should be made after careful consideration, consultation with healthcare professionals experienced in transgender healthcare, and discussions about potential risks, benefits, and implications.

Every individual’s journey and surgical plan are unique. It’s crucial to support and respect each person’s decision in navigating their gender identity and accessing the necessary healthcare and surgical interventions that align with their individual needs and goals.

Vaginectomy

Vaginectomy is a surgical procedure that involves the removal of the vagina. This surgery is typically part of gender-affirming surgery for individuals assigned female at birth (AFAB) who identify as male or on the masculine spectrum, often as part of female-to-male (FTM) bottom surgery. Here are key details about vaginectomy:

  1. Purpose:
  • The primary purpose of vaginectomy is to align an individual’s physical anatomy with their gender identity. For transmasculine individuals, vaginectomy is often performed as part of a comprehensive gender confirmation surgery.
  1. Gender-Affirming Surgery:
  • Vaginectomy is a component of gender-affirming surgeries that aim to alter the genitals to match an individual’s gender identity. It is commonly combined with other procedures like hysterectomy and phalloplasty or metoidioplasty.
  1. Techniques:
  • There are various surgical techniques for vaginectomy, and the specific approach may depend on the surgeon’s expertise and the individual’s unique anatomy. Techniques may involve laparoscopic or open surgical procedures.
  1. Hysterectomy:
  • In many cases, vaginectomy is performed in conjunction with a hysterectomy, which involves the removal of the uterus. This combination addresses both the internal and external aspects of the female reproductive anatomy.
  1. Scrotoplasty:
  • Scrotoplasty, a procedure to create a scrotum, may be performed simultaneously with vaginectomy, particularly when the individual opts for phalloplasty or metoidioplasty.
  1. Phalloplasty or Metoidioplasty:
  • Vaginectomy is often part of the overall process for those pursuing genital reconstruction surgeries like phalloplasty (construction of a penis using a graft) or metoidioplasty (enhancement of the clitoral tissue).
  1. Postoperative Recovery:
  • Recovery from vaginectomy involves a healing process, and individuals should follow postoperative care instructions provided by their healthcare team. This may include restrictions on physical activities, wound care, and pain management.
  1. Risks and Complications:
  • As with any surgical procedure, vaginectomy carries risks and potential complications. These may include bleeding, infection, changes in sensation, and scarring. The likelihood of complications is influenced by various factors, including individual health and surgical technique.
  1. Emotional Support:
  • Emotional support is crucial during the recovery process. Transgender individuals undergoing gender-affirming surgeries may experience a range of emotions, and access to mental health professionals and support networks is important.
  1. Impact on Sexual Function: – Vaginectomy may impact sexual function and sensations. Understanding the potential changes and discussing sexual health concerns with healthcare providers before the surgery is important.

It’s important for individuals considering vaginectomy to consult with experienced gender-affirming surgeons, discuss their goals and expectations, and thoroughly understand the potential outcomes and risks associated with the procedure. Additionally, ongoing postoperative care, including psychological support, is integral to the overall well-being of the individual undergoing this surgery.

 

Female-to-Male (FTM) surgery

Female-to-Male (FTM) surgery, also known as masculinizing or gender-affirming surgery, is a set of procedures designed to align the physical characteristics of an individual assigned female at birth with their male gender identity. These surgeries are part of a broader process of gender transition and may include various components. It’s important to note that not all individuals undergoing gender transition choose to undergo surgery, and the decision is highly individual. Here are key details on FTM surgery:

  1. Top Surgery (Chest Masculinization):
  • Top surgery is a common FTM procedure that involves the removal of breast tissue to create a more masculine chest contour. It can include mastectomy (chest reconstruction) with or without nipple grafts.
  1. Hysterectomy:
  • Hysterectomy involves the removal of the uterus. Some individuals opt for a hysterectomy as part of their gender transition to eliminate the need for reproductive health care associated with a uterus.
  1. Oophorectomy:
  • Oophorectomy is the removal of the ovaries. This procedure may be performed in conjunction with a hysterectomy or separately to reduce estrogen production in the body.
  1. Vaginectomy:
  • Vaginectomy is the surgical removal of the vagina. It is often performed as part of bottom surgery to address the internal reproductive organs and align the physical anatomy with the individual’s male gender identity.
  1. Metoidioplasty:
  • Metoidioplasty is a type of bottom surgery that involves enhancing the clitoral tissue to create a neophallus. This procedure allows for a more natural appearance and can be combined with urethral lengthening.
  1. Phalloplasty:
  • Phalloplasty is another option for bottom surgery and involves constructing a penis using grafts from other parts of the body. This complex procedure may include the creation of a urethra for standing urination.
  1. Scrotoplasty:
  • Scrotoplasty is a procedure that creates a scrotum. It is often performed in conjunction with metoidioplasty or phalloplasty to complete the external male genitalia.
  1. Urethral Lengthening:
  • Urethral lengthening may be performed to extend the urethra, allowing individuals who have undergone phalloplasty to urinate from their neophallus while standing.
  1. Glansplasty:
  • Glansplasty is a procedure that shapes and refines the head of the neophallus, providing a more natural appearance.
  1. Facial Masculinization Surgery: – Some individuals may opt for facial masculinization surgery, which can include procedures to alter features such as the jawline, forehead, or Adam’s apple to create a more masculine appearance.
  2. Voice Surgery: – Some individuals may undergo voice surgery or voice training to achieve a deeper and more masculine vocal tone.
  3. Psychological Support: – FTM surgery often involves significant physical and emotional changes. Access to psychological support, including counseling and support groups, is crucial for navigating these changes and addressing any emotional challenges.

Before undergoing FTM surgery, individuals typically undergo a comprehensive assessment by healthcare professionals experienced in gender-affirming care. This process ensures that individuals are well-informed about the procedures, potential risks, and expected outcomes. The decision to undergo surgery is deeply personal and varies among transgender individuals based on their unique goals and preferences.

Gender-affirming surgery

Gender-affirming surgery is a set of medical procedures designed to help individuals align their physical characteristics with their gender identity. These surgeries are an integral part of gender transition for many transgender individuals, providing them with the opportunity to express their gender in a way that feels authentic and comfortable. It’s important to note that not all transgender individuals pursue or desire gender-affirming surgery, and the decision is deeply personal. Here are key details about gender-affirming surgery:

  1. Purpose:
  • The primary purpose of gender-affirming surgery is to alleviate gender dysphoria, a distressing disconnect between one’s gender identity and assigned sex at birth. By modifying physical characteristics, individuals can align their bodies with their gender identity.
  1. Top Surgery:
  • Top surgery involves procedures to alter the chest, such as mastectomy (breast removal) for transmasculine individuals or breast augmentation for transfeminine individuals.
  1. Bottom Surgery:
  • Bottom surgery includes procedures that address the genital region. For transmasculine individuals, this may involve procedures like metoidioplasty or phalloplasty. For transfeminine individuals, it may include vaginoplasty or labiaplasty.
  1. Hysterectomy and Oophorectomy:
  • Some transgender individuals pursue surgeries such as hysterectomy (removal of the uterus) and oophorectomy (removal of the ovaries) to eliminate reproductive organs associated with their assigned sex.
  1. Facial Feminization Surgery (FFS) or Facial Masculinization Surgery (FMS):
  • FFS or FMS includes procedures to alter facial features, providing individuals with a more feminine or masculine appearance, respectively.
  1. Voice Surgery:
  • Voice surgery or voice training may be pursued to modify the pitch and resonance of the voice, helping individuals achieve a vocal tone that aligns with their gender identity.
  1. Tracheal Shave:
  • Transfeminine individuals may undergo a tracheal shave to reduce the prominence of the Adam’s apple, contributing to a more feminine neck contour.
  1. Gluteal Augmentation:
  • Some individuals may opt for gluteal augmentation to enhance the appearance of the buttocks, achieving a more feminine or masculine contour.
  1. Adam’s Apple Reduction:
  • Transfeminine individuals may seek an Adam’s apple reduction to soften the prominence of the thyroid cartilage, creating a more feminine neck profile.
  1. Chest Contouring: – For transfeminine individuals, chest contouring procedures may be performed to provide a more feminine appearance, including breast augmentation or breast reduction.
  2. Urethral Lengthening: – In certain bottom surgery procedures, such as phalloplasty, urethral lengthening is performed to allow for standing urination.
  3. Psychological Assessment: – Prior to undergoing gender-affirming surgery, individuals typically undergo psychological assessments to ensure they are well-informed about the procedures, have realistic expectations, and are emotionally prepared for the changes.
  4. Postoperative Support: – Ongoing postoperative care and support are crucial. This includes follow-up appointments, monitoring for complications, and access to mental health professionals who specialize in gender-related issues.
  5. Legal and Social Aspects: – Gender-affirming surgery is often one aspect of a broader gender transition. Individuals may also address legal and social aspects, such as name and gender marker changes on identification documents.

Gender-affirming surgery is a complex and individualized process. Access to knowledgeable and supportive healthcare professionals, as well as a strong support network, is critical for individuals considering or undergoing these surgeries. The decision to pursue gender-affirming surgery is deeply personal and should be made with careful consideration and informed consent.

Bottom surgery

Bottom surgery, also known as genital reconstruction or gender-affirming surgery, is a set of surgical procedures designed to modify the genitalia to align with an individual’s gender identity. The specific procedures chosen depend on whether the person is undergoing male-to-female (MTF) or female-to-male (FTM) transition. Here are details on both types of bottom surgery:

Male-to-Female (MTF) Bottom Surgery:

  1. Vaginoplasty:
    • Vaginoplasty is a common MTF procedure that involves the creation of a neovagina using penile and scrotal tissues. The procedure may include removal of the testes, reshaping the glans penis into a clitoris, and constructing the labia.
  2. Orchiectomy:
    • Orchiectomy is the surgical removal of the testes. Some MTF individuals undergo orchiectomy as a standalone procedure or as part of the vaginoplasty process to reduce testosterone production.
  3. Labia Construction:
    • Labia construction is part of vaginoplasty, where the surgeon creates labia minora and labia majora using reshaped penile and scrotal tissues.
  4. Clitoroplasty:
    • Clitoroplasty involves reshaping the glans penis into a clitoris. This is done to enhance sexual sensation and create a more feminine appearance.
  5. Vaginal Canal Depth:
    • The depth of the neovagina varies depending on the surgical technique and individual factors. Dilators are often used postoperatively to maintain depth and prevent stenosis.
  6. Postoperative Care:
    • Postoperative care for MTF bottom surgery includes wound care, dilation exercises to maintain vaginal depth, and follow-up appointments with the surgical team. Hormone therapy may also be continued.

Female-to-Male (FTM) Bottom Surgery:

  1. Metoidioplasty:
    • Metoidioplasty involves enhancing the clitoral tissue to create a neophallus. This procedure allows for standing urination and may include procedures like scrotoplasty and urethral lengthening.
  2. Scrotoplasty:
    • Scrotoplasty is the creation of a scrotum using labial and other tissues. It can be performed in conjunction with metoidioplasty or phalloplasty.
  3. Urethral Lengthening:
    • Urethral lengthening is performed to extend the urethra, allowing the individual to urinate from the neophallus while standing.
  4. Phalloplasty:
    • Phalloplasty is a more complex procedure that involves constructing a penis using grafts from other parts of the body, such as the forearm, thigh, or abdomen. It may include scrotoplasty and urethral lengthening.
  5. Glansplasty:
    • Glansplasty is a procedure that shapes and refines the head of the neophallus, providing a more natural appearance.
  6. Testicular Implants:
    • In both metoidioplasty and phalloplasty, testicular implants can be inserted into the scrotum to enhance the aesthetic appearance.
  7. Postoperative Care:
    • Postoperative care for FTM bottom surgery includes wound care, monitoring for complications, and follow-up appointments. Dilators may be used in the case of metoidioplasty, and erectile devices may be recommended for phalloplasty.

It’s important to note that bottom surgery is a significant and often irreversible step in the gender transition process. Individuals considering these procedures undergo thorough evaluations by healthcare professionals to ensure they are physically and emotionally prepared. The decision to pursue bottom surgery is highly individual, and not all transgender individuals choose to undergo these procedures. Access to knowledgeable healthcare providers, psychological support, and a strong support network are crucial elements in the journey of those considering or undergoing bottom surgery.

 

Masculinizing surgery

Masculinizing surgery, also known as female-to-male (FTM) gender-affirming surgery, is a set of procedures designed to modify the physical characteristics of individuals assigned female at birth to align with their male gender identity. These surgeries are an essential part of the gender transition process for many transgender individuals. Here are key details on masculinizing surgeries:

Top Surgery (Chest Masculinization):

  1. Double Incision Mastectomy:
    • Double incision mastectomy is a common procedure for FTM individuals seeking chest masculinization. It involves the removal of breast tissue, excess skin, and nipple grafts to create a more masculine chest contour.
  2. Periareolar Mastectomy:
    • Periareolar mastectomy, also known as keyhole or peri mastectomy, is a procedure suitable for individuals with smaller breasts. It involves removing breast tissue through a circular incision around the areola, preserving the nipple when feasible.
  3. Nipple Grafts:
    • Nipple grafts are often performed during mastectomy to relocate and resize the nipples for a more masculine appearance.

Bottom Surgery (Genital Reconstruction):

  1. Metoidioplasty:
    • Metoidioplasty involves enhancing the clitoral tissue to create a neophallus. This procedure allows for standing urination and may include procedures like scrotoplasty and urethral lengthening.
  2. Scrotoplasty:
    • Scrotoplasty is the creation of a scrotum using labial and other tissues. It can be performed in conjunction with metoidioplasty or phalloplasty.
  3. Urethral Lengthening:
    • Urethral lengthening is performed to extend the urethra, allowing the individual to urinate from the neophallus while standing.
  4. Phalloplasty:
    • Phalloplasty is a more complex procedure that involves constructing a penis using grafts from other parts of the body, such as the forearm, thigh, or abdomen. It may include scrotoplasty and urethral lengthening.
  5. Glansplasty:
    • Glansplasty is a procedure that shapes and refines the head of the neophallus, providing a more natural appearance.
  6. Testicular Implants:
    • In both metoidioplasty and phalloplasty, testicular implants can be inserted into the scrotum to enhance the aesthetic appearance.

Other Masculinizing Surgeries:

  1. Facial Masculinization Surgery (FMS):
    • FMS includes procedures to alter facial features, such as the jawline, forehead, or Adam’s apple, to create a more masculine appearance.
  2. Voice Surgery or Training:
    • Voice surgery or training may be pursued to modify the pitch and resonance of the voice, helping individuals achieve a deeper and more masculine vocal tone.
  3. Tracheal Shave:
    • A tracheal shave is a procedure to reduce the prominence of the Adam’s apple, contributing to a more masculine neck contour.

Postoperative Care:

  • Postoperative care for masculinizing surgeries includes wound care, monitoring for complications, and follow-up appointments.
  • Dilators may be used in the case of metoidioplasty, and erectile devices may be recommended for phalloplasty.
  • Psychological support is crucial for managing the emotional aspects of recovery and adjusting to the physical changes.

Considerations:

  • The decision to undergo masculinizing surgery is highly individual, and not all transgender individuals choose to pursue all available procedures.
  • Access to knowledgeable healthcare providers and a strong support network is essential for those considering or undergoing masculinizing surgery.

Masculinizing surgery is a significant and often life-changing step in the gender transition process. It is essential for individuals to thoroughly discuss their goals, expectations, and potential outcomes with experienced healthcare professionals who specialize in gender-affirming care.

 

Transmasculine surgery

Transmasculine surgery, also known as female-to-male (FTM) gender-affirming surgery, encompasses a range of procedures designed to help individuals assigned female at birth align their physical characteristics with their male gender identity. The specific surgeries chosen vary among individuals based on their preferences, goals, and overall transition journey. Here are details on various transmasculine surgeries:

Top Surgery (Chest Masculinization):

  1. Double Incision Mastectomy:
    • Double incision mastectomy is a common procedure for transmasculine individuals seeking chest masculinization. It involves the removal of breast tissue, excess skin, and nipple grafts to create a more masculine chest contour.
  2. Periareolar Mastectomy:
    • Periareolar mastectomy, also known as keyhole or peri mastectomy, is a procedure suitable for individuals with smaller breasts. It involves removing breast tissue through a circular incision around the areola, preserving the nipple when feasible.
  3. Nipple Grafts:
    • Nipple grafts are often performed during mastectomy to relocate and resize the nipples for a more masculine appearance.

Bottom Surgery (Genital Reconstruction):

  1. Metoidioplasty:
    • Metoidioplasty involves enhancing the clitoral tissue to create a neophallus. This procedure allows for standing urination and may include procedures like scrotoplasty and urethral lengthening.
  2. Scrotoplasty:
    • Scrotoplasty is the creation of a scrotum using labial and other tissues. It can be performed in conjunction with metoidioplasty or phalloplasty.
  3. Urethral Lengthening:
    • Urethral lengthening is performed to extend the urethra, allowing the individual to urinate from the neophallus while standing.
  4. Phalloplasty:
    • Phalloplasty is a more complex procedure that involves constructing a penis using grafts from other parts of the body, such as the forearm, thigh, or abdomen. It may include scrotoplasty and urethral lengthening.
  5. Glansplasty:
    • Glansplasty is a procedure that shapes and refines the head of the neophallus, providing a more natural appearance.
  6. Testicular Implants:
    • In both metoidioplasty and phalloplasty, testicular implants can be inserted into the scrotum to enhance the aesthetic appearance.

Other Transmasculine Surgeries:

  1. Facial Masculinization Surgery (FMS):
    • FMS includes procedures to alter facial features, such as the jawline, forehead, or Adam’s apple, to create a more masculine appearance.
  2. Voice Surgery or Training:
    • Voice surgery or training may be pursued to modify the pitch and resonance of the voice, helping individuals achieve a deeper and more masculine vocal tone.
  3. Tracheal Shave:
    • A tracheal shave is a procedure to reduce the prominence of the Adam’s apple, contributing to a more masculine neck contour.

Postoperative Care:

  • Postoperative care for transmasculine surgeries includes wound care, monitoring for complications, and follow-up appointments.
  • Dilators may be used in the case of metoidioplasty, and erectile devices may be recommended for phalloplasty.
  • Psychological support is crucial for managing the emotional aspects of recovery and adjusting to the physical changes.

Considerations:

  • The decision to undergo transmasculine surgery is highly individual, and not all transgender individuals choose to pursue all available procedures.
  • Access to knowledgeable healthcare providers and a strong support network is essential for those considering or undergoing transmasculine surgery.

Transmasculine surgery is a significant and often life-changing step in the gender transition process. It is essential for individuals to thoroughly discuss their goals, expectations, and potential outcomes with experienced healthcare professionals who specialize in gender-affirming care.

 

Vaginoplasty alternatives

Vaginoplasty is a surgical procedure that involves the creation of a neovagina for individuals undergoing male-to-female (MTF) gender confirmation surgery. While vaginoplasty is a common and well-established procedure, there are alternative methods and considerations that individuals may explore based on their preferences, medical history, and desired outcomes. Here are some vaginoplasty alternatives:

  1. Colon or Sigmoid Colon Vaginoplasty:
    • In cases where the penile and scrotal tissues are insufficient for vaginoplasty, surgeons may use a segment of the colon or sigmoid colon to create a neovagina. This method allows for the development of a functional and self-lubricating neovagina.
  2. Peritoneal Pull-Through Vaginoplasty:
    • Peritoneal pull-through vaginoplasty is a technique that uses peritoneal tissue lining the abdominal cavity to create the neovagina. This method may be suitable for individuals who do not wish to use penile or scrotal tissue.
  3. Zero Depth or Non-Penetrative Vaginoplasty:
    • Some individuals may choose not to undergo a fully penetrative vaginoplasty and opt for a zero depth or non-penetrative vaginoplasty. This procedure focuses on creating external genitalia without constructing a vaginal canal.
  4. Labia Construction Only:
    • For those who do not desire a neovagina, labiaplasty or labia construction alone can be performed to create external labia minora and labia majora for a more feminine appearance.
  5. Vulvoplasty or Vulvectomy:
    • Vulvoplasty involves the creation of external female genitalia without the formation of a vaginal canal. In some cases, individuals may choose vulvectomy, which focuses on the external appearance of the vulva without internal modifications.
  6. Clitoroplasty Alone:
    • Some individuals may choose to undergo clitoroplasty alone, without constructing a neovagina. This procedure involves reshaping the glans penis into a clitoris to enhance sexual sensation.
  7. Minimal Depth Vaginoplasty:
    • A minimal depth vaginoplasty involves creating a neovagina with a shallower depth compared to traditional vaginoplasty. This option may be suitable for individuals who prioritize aesthetics and external appearance.
  8. Combination Procedures:
    • Some individuals may opt for a combination of procedures, choosing aspects of various techniques to achieve their desired outcomes. This could involve a combination of penile, scrotal, or other tissues based on individual preferences.

It’s crucial for individuals considering gender confirmation surgeries, including alternative approaches, to consult with experienced gender-affirming surgeons and healthcare professionals. The decision-making process should involve thorough discussions about goals, expectations, potential risks, and desired outcomes. Each person’s journey is unique, and the choice of surgical approach depends on individual factors and preferences. Access to knowledgeable healthcare providers and psychological support is vital for those exploring gender-affirming surgeries and alternatives.