FTM Gender Confirmation: Genital Construction

What is a female to male (FTM) gender reassignment surgery?

Female to male (FTM) gender reassignment surgery is also known as sex reassignment surgery (SRS), genital construction, and generally as gender confirmation surgery. These plastic surgery procedures are used by transgender patients to remove and alter female genitalia into traditional male genitalia.

Plastic surgeons will usually perform a hysterectomy and salpingo-oophorectomy to remove the uterus and ovaries. A vaginoplasty or vaginectomy will close the vagina, the erectile tissue of the clitoris is released and with the mons portion of the pubic area a neo-phallus is created (phalloplasty or metoidioplasty). The labia majora then become the scrotum (scrotoplasty), bilateral testicular implants are placed, and finally the urethra is lengthened through the newly created penile tissue.

Typically gender reassignment surgery is performed as a last step in a transgender individuals transition journey. Guidelines on standards of care from The World Professional Association for Transgender Health (WPATH) state candidates must have letters of recommendation from their mental health professional and healthcare provider, have been living full time as a man for one year, and have completed one year of hormonal therapy to be eligible.

Information on facial masculinization surgeries, top surgeries (like a mastectomy), and other female to male gender affirming surgeries as part of a gender transition for transmen can be found in our comprehensive guide to FTM gender affirmation solutions.

What concerns does a FTM gender reassignment surgery treat?

1. Transmasculine Bottom Surgery & Genital Construction: Female to male gender reassignment surgery creates male genitalia that are aesthetically authentic and functional.

Who is the ideal candidate for a FTM gender reassignment surgery?

The ideal candidate for FTM gender reassignment surgery is a transgender man seeking to complete his physical embodiment of his gender identity. This reconstructive genital surgery creates functioning male genitalia. FTM gender reassignment surgery is not recommended for those who have not been on hormone therapy for one year, have not been living full time as a man for one year, do not have letters of recommendation from their mental health provider and physician, children under the age of 18, and those with certain chronic medical conditions.

What is the average recovery associated with a FTM gender reassignment surgery?

Most patients experience four to six weeks of recovery time following a FTM gender reassignment surgery. Patients can expect bruising, swelling, and tenderness following the procedure. A urinary catheter is typically used for two to three weeks.

What are the potential side effects of a FTM gender reassignment surgery?

Possible side effects following a FTM gender reassignment surgery include bleeding, swelling, bruising, incision site infection, altered sensation, difficulty urinating due to strictures, difficulty with sexual function, prolonged edema, and complications from anesthesia or the procedure.

What can someone expect from the results of a FTM gender reassignment surgery?

The results of FTM gender reassignment surgery are permanent. This procedure creates functional male genitalia and removes all female genitalia.

What is the average cost of a FTM gender reassignment surgery?

FTM gender reassignment surgery costs generally exceed $50,000. The actual cost of a surgical procedure will be dependent on location, surgeon, and length and involvement of the surgery.