The 2015 U.S. Transgender Survey found that approximately 50% oftransgendermen wanted or had undergone such a surgery.
The other half were interested in a metoidioplasty.
What Is Metoidioplasty?
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Metoidioplasty is the creation of a phallus (penis) from the hormonally-enlarged clitoris.
The clitoris naturally enlarges when a person begins to take testosterone.
A minimum of a year on testosterone is a requirement for all transmasculine genital surgeries.
(Depending on the individual, this is not always a concern.)
Metoidioplasty can be done either with or without urethral lengthening procedures.
Urethral lengthening extends the urethra along the new phallus.
Then, one is able to urinate from their phallus.
However, urethral lengthening does increase the risk of surgical complications.
Being able to stand to urinate is a major reason that transmasculine people choose to undergo genital surgery.
Metoidioplasty is usually considered to be a single-stage surgery.
However, some people may require additional surgeries to make it achieve their desired results.
Additional surgeries may address either appearance or function.
What Is Phalloplasty?
Phalloplasty is the construction of a neophallus or reconstruction of a penis.
This procedure is used to create a phallus in gender confirmation surgery.
The surgery has decreased in frequency in favor of metoidioplasty, which is a more recently developed procedure.
Metoidioplasty vs. Phalloplasty
There are advantages and disadvantages to both metoidioplasty and phalloplasty.
Many people who choose metoidioplasty are happy with the outcome of their surgery.
However, the reverse is not true.
The procedure for embedding the clitoris in the penis during phalloplasty makes a later metoidioplasty not feasible.
These procedures are abdominal surgeries used to remove the uterus and ovaries.
Removing the uterus, cervix, and ovaries also eliminates the need for gynecological screening.
This needs to be done prior to ovariectomy and hysterectomy.
Ideally, it should also be done before starting testosterone therapy, but that is not a requirement.
Vaginectomy
Vaginectomy is the surgical removal (or closing up) of the vagina.
Some surgeons who offer phalloplasty and/or metoidioplasty will offer this surgery as part of a single-stage reconstruction.
Others prefer patients to have a vaginectomy in advance if that is something the patient wants.
More research needs to be done to establish the risks of vaginectomies.
The outcome of such procedures is likely closely related to the skills and experience of the surgeon.
Outside the context of gender-affirming surgery, this procedure is primarily used to treat certain types of gynecologic cancer.
As such, some plastic surgeons may refer patients interested in vaginectomy to a surgical gynecologist.
Scrotoplasty
Scrotoplasty is the construction or repair of the scrotum.
This procedure can be done on its own or as part of a vaginectomy.
The scrotum is created out of the labia majora of the vulva.
Sometimes, multiple procedures are required to stretch and grow enough skin.
Silicone prosthetic testicles can then be inserted into the newly formed scrotum.
This could include not just your surgeon but yourtherapistor friends who have gone through a similar decision-making process.
However, remember that different people have different preferences and motivations.
There are many areas of the country with no surgeons, or only one surgeon, performing these procedures.
Other Factors to Consider
What additional surgeries people choose are a matter of individual preference.
National Center for Transgender Equality.
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