• Sex change from Female to Male (FTM)

    See services Female to Male surgery clinic in Bangkok, Thailand

Sex Reassignment

Female to Male reassignment surgery

Introduction

A female to male sex reassignment surgery involves a couple of procedures for transgender males to transform the female anatomical features so as to obtain physical traits with more masculine identity and functionality.

A good number of trans men have undergone numerous procedures such as genital reassignment surgery, bilateral mastectomy (breast removal), and chest contouring (to achieve a more characteristically male trunk silhouette), and hysterectomy (removing internal sex organs).

Usually, a hormone treatment with testosterone comes before the sex reassignment procedure takes place.

A genital reconstructive procedure (GRT) can enlarge the clitoris using androgenic hormones in a process called metoidioplasty or make use of extra tissue grafts obtained from body parts such as the arm, tummy or thigh along with an erectile prosthetic in a procedure called phalloplasty.

Whichever the option, it’s still possible to reroute via the phallus to pave the way for urination using the freshly created penis. Then a scrotum is formed by uniting labia majora to provide an opening that can be used to insert prosthetic testicles. Most men prefer the latter. If they opt to go for the earlier procedure, most of them usually go for the phalloplasty procedure later on. Our clinic only avails the Metoidioplasty services

2. Approval Criteria by WPATH (World Professional Association for Transgerder Health)

2.1 Attained 18 years of age, and permission from parents if below 20.

2.2 Prove of diagnosis for gender identity disorder, gender dysphoria, or related conditions.

2.3 At least one year of administering antiandrogens or female hormones.

2.4 Proof to have lived full-time in the cross-gender function for not less than a year (include Identification Documents).

2.5 Mandatory approval by a psychiatrist (MD), psychiatric social worker (Ph.D), or clinical psychologist (Ph.D).

Pre-Operation
  • Do not take hormones two weeks prior to surgery to lower the likelihood of blood clots in the veins. Get admission to the hospital a day before SRS surgery for cleaning of the bowels. This should more than 18 hours before actual surgery.
  • Restrict consumption to clear liquids. Avoid solid food 1 day to operation.
  • Apply 2.5% dihydrotestosterone gel (FTM metoidioplasty patients) on the clitoris twice every day for a minimum of 1 month to double its size.
  • You can also use tiny vacuum devices for about 2-3 months to increase size.
The Procedure
  1. Subcutaneous mastectomy
    More information on this is available on mastectomy page
  2. Hysterectomy or Complete removal of uterus and ovaries removal
    • Surgical removal of uterus and ovaries for immediate menopause take-off
  3. Genital reconstructive procedures (GRT): Metoidioplasty
    • It is called Phallus technique
    • Non-invasive surgery to preserve natural senses and erectile function.
    • Avoidance of donor site forearm scars
    • Pubic lipectomy can provide greater lengths for overweight patients, which will recess the body surface line.
    • Lifting the clitoral covering, and then detaching the suspensory tendon of the clitoris starting from the pubic bone. This allows the clitoris to elongate further. After priming the feminine tissues through testosterone, the clitoral top may look a lot like an adolescent gland penis, even though it may actually be smaller.
    • Your prior experience with testosterone and clitoromegaly will help know what to expect when you self-examine your glands and clitoral parts 6 to 8 weeks following the surgery.
    • Visible engorgement may take place when aroused, however the phallus is not appropriate for penetration, neither is ejaculation achievable.
    • For patients considering standing to void, the urethra is pulled out into the neo-penis. It is be done either concurrently or it performed in another procedure through a vaginal dither or buccal mucosal implant.
    • The procedure works best for patients that had laparoscopic assisted vaginal total hysterectomy with amputation of tubes and ovaries. It is followed by a vaginal closure (colpocleisis).
    • The procedure will achieve a small size penile which cannot engage in sex.

    Advantages

    • Natal-appearing penis
    • Erotic sensation
    • Unaided erections
    • Easily covered scars
    • Shorter operative duration
    • Shorter recovery period

    Disadvantages

    • Small sized penis
    • Hormonally stimulates clitoral growth needed
    • Usually, no bulge produced
    • Based on the surgical technique, scrotum may take a bifid appearance until further correction
    • Urethroplasty may not facilitate standing to void.
Post Operation
  • Perineal drainage that takes about 2-3 days
  • Recovery in hospital for 5-7 days, or 3-5 nights
  • You can drive a week after leaving the hospital, resume work in 10-14 days, participate in sports after two weeks, and enjoy non-penetrative sex after 30 days.
Complication
  • Fistula (hole) or stricture (blockage) with urethroplasty
  • Relocation and/or extrusion of testicular implants. (There is less risk linked to the Simple Meta procedure because urethroplasty is not done.)