Masculinizing/Defeminizing Procedures
Our team of expert surgeons provides a wide-ranging set of options for masculinizing/defeminizing procedures to help alter your body’s physical appearance to reflect your gender identity. Masculinizing/defeminizing surgical procedures include numerous options, such as “top” surgery, “bottom” surgery, and facial or body contouring procedures. Some gender-affirming surgical services offered at UI Health are: mastectomy/chest surgery, hysterectomy/oophorectomy, metoidioplasty, phalloplasty, penile/testicular prosthesis, body contouring and fertility preservation.
If you have any questions or concerns about these procedures our team of experts is here to help you. In addition to proving safe high-quality care and surgical expertise, we are committed to being your healthcare partners throughout your transition and to helping you achieve the desired results you want.
Complete List of Procedures:
- Mastectomy/Chest Surgery – A bilateral mastectomy is the removal of the breasts. Whether your goal is to masculinize or de-feminize your chest contour, you and your surgeon will discuss options for the type of incision based on your body and your goals. This surgery can be done with or without preservation of the nipple. This is usually an outpatient surgery, and you will go home the same day.
- Hysterectomy/Oophorectomy – A Hysterectomy is the removal of the uterus, and a salpingo-oophorectomy is the removal of the bilateral fallopian tubes and ovaries. The ovaries not only make estrogen, they are also the storage for ova (eggs), so removing them prevents future harvest of ova. If you are considering Fertility preservation, ova may be harvested before surgery. This is an irreversible procedure.
- Metoidioplasty – A Metoidioplasty is the creation of a small penis and possible urethral extension using the existing genital tissue. The post-operative length of the penis ranges from 4 to 6cm on average. Typical goals achieved by this surgery include the ability to stand while urinating, closure of the vaginal canal, and the potential creation of a scrotum. Due to the limited length of the penis, it does not allow for penetrative intercourse. If your goals include the closure of the vaginal canal, you must first have a total hysterectomy to remove the cervix due to the related risk of future cervical cancer.
- Phalloplasty – A Phalloplasty is the creation of a penis and potential urethral lengthening using both the existing genital tissue and a flap from either the forearm, thigh, or side of the torso. Phalloplasty is typically a two-stage surgery, with a metoidioplasty as the first stage, and the addition of the flap for extended penile and further urethral length as the second. Closure of the vaginal canal and creation of a scrotum is often performed during the primary metoidioplasty surgery. The post-operative length of the phallus ranges from 5 to 6 inches on average. Typical goals achieved by this surgery include the ability to stand and void, as well as the potential for future penetrative intercourse using either an inflatable or malleable penile prosthesis (placed in a separate procedure).
- Penile/Testicular Prosthesis – Penile Prosthesis may be placed 1 year after phalloplasty, or once your body has had time to completely heal. Penile prostheses may be either malleable or inflatable, and it may be placed in combination with testicular implants. Typically this is either an overnight stay in the hospital or an outpatient procedure.
Testicular Prosthesis may be placed after metoidioplasty or phalloplasty once your body has had time to completely heal. If your metoidioplasty is a primary stage for future phalloplasty, we will wait until after your phalloplasty for placement of any prosthesis. This is an outpatient procedure. - Body Contouring – Though bodies come in all shapes and sizes, there are some curves typically ascribed as feminine curves such as wider hips, rounder buttocks, smaller waist, or “hourglass” shape. Likewise, an “A-frame” shape or less curvature in the hips and thighs is generally perceived as more masculine. Though hormones affect where fat is distributed on the body, body contouring may help you achieve the body shape that feels natural to you. You and your surgeon will discuss your personal goals as well as areas of your body that increase your dysphoria. This is usually an outpatient surgery, and you will go home the same day.
- Fertility preservation – Prior to removal of the testicles or ovaries, you and your surgeon will discuss whether you would like to preserve sperm or eggs for potential biological reproduction. Should you wish to consider that option, your surgeon will refer you to our fertility preservation specialist for further discussion.
