All Procedures
What Is Male to Female Gender Reassignment/ Confirmation Surgery (MTF GRS)?
Male-to-female gender affirmation surgery (also known as gender confirmation surgery or gender reassignment surgery, often abbreviated as MTF GRS) is a complex and irreversible set of procedures for trans women who experience gender dysphoria and have a strong desire to align their physical characteristics with their gender identity.
The procedure typically involves the removal of male genital structures, including the penis and testes, and the creation of female genitalia. This includes the formation of the labia majora and minora, clitoris, and a neovagina. The aim is to help individuals achieve greater comfort and confidence in their gender identity.
In addition to genital surgery, some individuals may choose to undergo other gender-affirming procedures to support their transition. These may include breast augmentation, facial feminization surgery, body contouring, hair removal, and voice-related procedures.
There are several techniques for neovaginal construction, depending on the type of genital or non-genital tissue used. These may involve genital tissue (such as penile and scrotal skin) or non-genital tissue (such as segments of the large intestine, small intestine, or peritoneum), either alone or in combination.
Please note: the surgery is quite complicated and only a handful of surgeons can perform this procedure.
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 in another gender role (Female 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 identify what the patient focuses on; New female genital appearance, Neovaginal function, Risk of complication, Secondary revision possibility, 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 5-8 hours. It can be completed in one stage or more stages depending on techniques and surgeons.
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
Is The Procedure Inpatient or Outpatient?
The patient will be hospitalized as an in-patient for between 5-14 days depending on the technique and surgeon. The patient will always have a urinary catheter in the hospital.
Additional Information
As with any major surgery, there are potential risks and complications. Your surgeon will discuss these with you in detail based on your individual case.
The most frequent complications of MTF 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
Some specific risks related to vaginoplasty include:
- Neovaginal contracture (narrowing of the vaginal canal), which may occur due to incomplete healing or inadequate post-operative dilation.
- Rectovaginal or urethrovaginal fistula (an abnormal connection between organs)
- Unsightly scar or deformed genitalia
- Altered or loss of sensation
In some cases, revision procedures may be recommended to improve function or external appearance. These can include secondary labiaplasty, urethroplasty, perineoplasty, vulvoplasty, or secondary vaginoplasty to support comfort and sexual function.
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 patient can return to their normal lives but are recommended to do physical exercise involving the lower body during the first 2 months after surgery.
The patient must do vaginal dilation continuously for 6 months to maintain the neovagina canal until completely healed and is ready for sexual intimacy.
With the good surgical technique, the result is very satisfying with an improved quality of life. The patient can live in a female role completely and happily either on their own or with their male or female 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.