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Phalloplasty and Metoidioplasty: Female to Male (FTM) Genital Reconstruction Surgery

Female to male genital reconstruction surgery is more challenging than male to female reconstruction and requires experience, expertise and preparation for optimal outcomes. With careful patient selection, preoperative planning and meticulous surgical techniques, the skilled gender-affirmation surgery team at University Hospitals can create an aesthetically pleasing and functional penis.

Things to Consider Before Having Female to Male (FTM) Genital Transition Surgery

  • If you would like to preserve your ability to have biological children in the future, talk to your doctor about harvesting and freezing your eggs prior to having surgery. Egg freezing is a multiple-step process and, if you want to freeze embryos, you will need to take the additional step of having your eggs fertilized.
  • Risks: Tissue necrosis (dead or damaged tissue) in the surgically created penis; blood clots in deep veins and/or the lungs; Fistulas - an abnormal opening between two body parts, such as in the urinary tract. Phalloplasties in particular have the potential for many complications so you should talk to your doctor about the risks and benefits of the procedure before proceeding.
  • It is always recommended that patients talk with a therapist in the months leading up to surgery to ensure they are mentally and emotionally prepared for the transition.
  • In accordance with the World Professional Association of Transgender health (WPATH) standards of care, we require that patients be on appropriate cross-gender hormone therapy for a year, live in the gender-congruent role for a year, and have 2 mental health letters endorsing their suitability for surgery.

Most genital gender affirmation surgeries are covered by insurance. In cases where they are not, your surgeon’s office will guide you through the self-pay options.

Surgical Techniques for Female to Male (FTM) Transition

There are two primary surgical procedures that may be offered for female to male genital transition – phalloplasty and metoidioplasty.