A guide to lower surgery for trans men - Gender Identity Research ...

There will be important choices to be made about intended outcomes. Your wishes
may have to be adjusted in light of the view of your surgeon about what is possible,
or likely to be achievable, in your case. Everyone’s anatomy is slightly different,
and your surgeon will take this into account.
Your penis will need to be created from your own tissue, as a graft, taken from a
donor site. Some surgeons prefer one donor site rather than another – forearm
rather than abdominal flap – for instance. The donor tissue is rolled into a basic
penis shape and may be positioned slightly differently, depending on:
whether the clitoris is to be buried under the penis or scrotum (if no
metoidioplasty has taken place) or left visible and accessible between the
testes;
whether or not metoidioplasty has already been carried out; if it has, then the
micro-penis will be incorporated into the penis by wrapping the donor tissue
around it; and
where the graft is taken from – an abdominal flap allows little choice of exact
position, whereas the forearm flap is ‘free’ and positioning is a little more
flexible.
You will also have to consider the various refinements that can be made on your
phallus. Do you want a phallus that looks good but is not functional? Is it important
to you to be able to urinate standing up? Are you hoping to be able to make the
penis erect and have penetrative sex?
As with the metoidioplasty, your surgeon should be able to provide you with
images, and may be able to refer you to other patients whom he or she has
treated. You will need to understand the risks associated with this complex
surgery, so that you are able to make joint decisions with the surgeon, and give
properly informed consent to each of the procedures.
N.b. The following text should only be regarded as an introduction to the possible
procedures that may be involved in phalloplasty. Techniques depend not only on
your choices, but also on the practice and experience of your surgeon, and your
own particular anatomy. It is not within the scope of this booklet to cover all these
possibilities.
© GIRES A GUIDE TO LOWER SURGERY FOR TRANS MEN
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