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Procedure: Female to Male Gender Reassignment Surgery (FTM GRS)
Useful information for patients on Female to Male Gender Reassignment Surgery (FTM GRS)
What Is Female to Male Gender Reassignment/Confirmation Surgery?
Female-to-male gender affirmation surgery (also known as gender confirmation surgery or gender reassignment surgery, often abbreviated as FTM GRS) refers to a group of complex surgical procedures for trans men who experience gender dysphoria and wish to align their physical characteristics with their gender identity.
These procedures may involve the removal of female reproductive organs, including the uterus, ovaries, and vaginal tissue, along with the construction of male genitalia, such as a penis and scrotum. The aim is to support individuals in feeling more comfortable and confident in their gender identity.
In addition to genital surgery, some individuals may choose to undergo other gender-affirming procedures. These can include chest (top) surgery, facial procedures, or body contouring.
Who Is It For?
The patient who is fit for this surgery must strictly follow the standard of care set by the World Professional Association of Transgender Healthcare (WPATH) or equivalent criteria:
- Express desire or live gender role (Male gender) long enough.
- Under hormonal replacement therapy.
- Evaluated and approved by a psychiatrist or other qualified professional gender therapist.
Preparation
Before surgery, patients typically undergo:
- An in-depth consultation: to focus on what the patient focuses on: removal of vagina, able to void while standing, size of neophallus, need for prosthesis, several stages of surgeries, risk of complication etc.
- A review of your medical history and any skin conditions
Useful Information
Ensure you consider all aspects of a procedure. You can speak to your surgeon about these areas of the surgery in more detail during a consultation.
Length
How Long Is the Procedure?
The average surgical time ranges between 2-3 hours.
It is a multi-staged procedure, the first stage is the removal of the uterus, ovary, and vagina and the average surgical time ranges between 2-3 hours. This stage might include Urethral prefabrication (Buried catheter technique). The second and later stages are penis and scrotum reconstruction (Phalloplasty) which is at least 6 months later, which can take from 3-5 hours. The patient will always have a urinary catheter in the hospital and retained for some time.
Anesthesia
Do I Need Anesthesia?
General anesthesia is commonly used for this procedure, although it might be combined with spinal anesthesia for faster recovery by reducing the usage of anaesthetic gas.
Inpatient/Outpatient
The patient will be hospitalized as an in-patient for between 5-7 days for each stage depending on the technique and surgeon. The patient will always have a urinary catheter in the hospital.
Additional Information
The most frequent complications of FTM GRS are:
- Bleeding
- Bruising or haematoma (a collection of blood under the skin)
- Wound infection
- Skin flap or graft necrosis (loss of tissue due to reduced blood supply)
- Urinary issues such as Urethral Fistula or Urethral Stricture
- Unsightly scar or deformed genitalia
- Altered or loss of sensation
The revision procedure is scar revision, correction of Urethral fistula, debulking of fat along Neophallus, hair transplant, or tattooing to camouflage unsightly scars.
During hospitalization, the patient must be restricted in bed continuously or intermittently for several days between 3-5 days. After release from the hospital, the patients return to their normal lives but are recommended not to do physical exercise involving the lower body during the first 2 months after surgery.
The patient will have a urinary catheter continuously for several weeks to avoid a urinary fistula. If the patient has a penile prosthesis, it will need at least 6 months before sexual intimacy.
During hospitalization, the patient must be restricted in bed continuously or intermittently for several days between 3-5 days. After release from the hospital, the patients return to their normal lives but not having to do physical exercise during the first 2 months after surgery. The patient will have a urinary catheter continuously for several weeks to avoid a urinary fistula. If the patient has a penile prosthesis, it would need at least 6 months before sexual intimacy.
With good surgical technique, the result is very satisfying with an improved quality of life. The patient is able to live in a male role completely and happily either on their own or with their female or male partners.
Please note: Individual results vary from patient to patient due to factors such as age, skin quality, body type, hormonal changes, and overall health. To understand what results you can expect, consult with a qualified aesthetic plastic surgeon.