Sex reassignment surgery from female to male includes surgical procedures that will reshape a female body to appear like that of a genetic male. Male sex hormones, testosterone, are also used to augment the whole transition process. The process is done in three separate stages with at least 3-6 months interval between each stage.
Because most of these procedures are irreversible, a comprehensive evaluation of the patient must be done by a qualified, board certified mental health professional. Letter of recommendation by these evaluating professionals are then required before breast and genital surgery can be done. In order to obtain this letter, the patient must meet the eligibility and readiness criteria as enumerated in the HBIGDA Standards of Care.
1st Stage (6 nights hospital stay)
- Mastectomy – Entails removal of the breasts and reshaping the chest to achieve male upper body contours. Different surgical techniques are used depending on the amount of breast tissue to be removed.
- Total Abdominal Hysterectomy with Bilateral Salpingo-oophorectomy - Surgery to remove the uterus, fallopian tubes and ovaries.
2nd Stage (8 nights hospital stay)
- Vaginectomy & Urethral Lengthening – This procedure is done to obliterate the vaginal cavity and to lengthen the urethra to carry urine out of the neophallus after phalloplasty.
- Urethral Prefabrication – Pre-formation of a new urethra in the patient’s forearm to allow passage of urine from the tip of the neo-phallus.
3rd Stage (14 nights hospital stay)
- Total Phalloplasty – Formation of a new adult-size phallus with sufficient length and bulk to allow passage of urine and penetration during sexual intercourse (with the aid of an erectile prosthetic device). Requires free tissue transfer usually from the forearm.
- Penile Prosthesis – Insertion of an erectile prosthetic material in order to achieve penetration during sexual intercourse. This is done at least a year after Phalloplasty.
