Masculinizing surgery

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Surgical procedures to develop male-typical anatomy in transgender men


Masculinizing surgery refers to a variety of surgical procedures that are performed to develop male-typical anatomy in individuals assigned female at birth who identify as male or non-binary. These surgeries are often part of gender-affirming surgery for transgender men and can include procedures such as chest reconstruction surgery, phalloplasty, and metoidioplasty.

Types of Masculinizing Surgery[edit | edit source]

Chest Reconstruction Surgery[edit | edit source]

Phalloplasty model

Chest reconstruction surgery, also known as "top surgery," is a procedure to remove breast tissue and create a masculine chest contour. This surgery is often one of the first steps in the physical transition process for transgender men. Techniques vary depending on the amount of breast tissue and the desired outcome, and may include double incision, periareolar, or keyhole techniques.

Phalloplasty[edit | edit source]

Phalloplasty is a complex surgical procedure that constructs a penis using tissue from other parts of the body, such as the forearm, thigh, or abdomen. This surgery can include the creation of a urethra, allowing for urination while standing, and may also involve the insertion of erectile and testicular implants. Phalloplasty is typically performed in multiple stages and can be customized to meet the individual's goals and anatomy.

Metoidioplasty[edit | edit source]

Metoidioplasty result 2 years post-op

Metoidioplasty is a surgical technique that takes advantage of the clitoral growth induced by testosterone therapy. The procedure releases the clitoris from its surrounding tissue, allowing it to extend further and resemble a small penis. Metoidioplasty can also include urethral lengthening and scrotoplasty, where testicular implants are placed.

Hysterectomy and Oophorectomy[edit | edit source]

Many transgender men opt for a hysterectomy and oophorectomy as part of their transition. A hysterectomy involves the removal of the uterus, while an oophorectomy involves the removal of the ovaries. These procedures can be performed laparoscopically and are often done to eliminate menstruation and reduce the risk of certain cancers.

Considerations and Outcomes[edit | edit source]

Masculinizing surgeries are highly individualized, and the decision to undergo these procedures is personal. Factors such as desired outcomes, health considerations, and financial aspects play a significant role in the decision-making process. The outcomes of masculinizing surgeries can greatly enhance the quality of life and psychological well-being of transgender men by aligning their physical appearance with their gender identity.

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Contributors: Prab R. Tumpati, MD