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What types of gender-affirming surgical procedures are available to you during your transition (MTF)

July 20, 2020

Vaginoplasty – SRS (sex reassignment surgery) or GRS (genital reconsecration surgery) – The surgical construction of a vagina. This procedure commonly includes a clitoris, vaginal canal, and labia. Many different methods are available, depending on what you want. Most commonly used is the Penile inversion technique, but others exist, such as peritoneal pull through and sigmoid colon vaginoplasty. Dilation is used after surgery to make sure the depth you have is kept.

reference image for dilators

Dilation is needed almost indefinitely after surgery, even though in some methods, such as peritoneal pull through, the risk of losing depth is less. This procedure’s cost can be anywhere from $10,000 – 20,000 USD in Thailand to $25,000 – 75,000 USD in the U.S.A. Recovery usually takes 4-6 weeks; most people resume work at the 2-month mark. Therapists or doctor’s notes are almost always required for you to go through this procedure. Laser or electrolysis hair removal is commonly required before surgery to ensure no hairs grow in the vagina.

Orchiectomy – The surgical removal of the testicles. When you remove the testicles, your body no longer procedures a large amount of natural testosterone. You can get off testosterone blockers and lower your dose of estrogen after an orchiectomy. Some trans women talk about additional breast growth after an orchiectomy. Not only that, but an orchiectomy makes tucking, the hiding of the crotch or groin, a lot easier. I personally have had one and would highly recommend it. If you want a vaginoplasty down the line, an orchiectomy seldom affects a vaginoplasty later.

Therapists or doctor’s notes are almost always required. The price can range from around 2,000-5,000 USD, and the recovery is about a week. Not everyone transitions will look the same. Some trans women talk about how the orchiectomy was all they needed to be happy with their genital. An orchiectomy can be done in conjunction with a Scrotectomy, the surgical removal of the scrotum. If you want a vaginoplasty down the line, it is a bad idea for you to remove the scrotum since the scrotum is usable tissue for the vaginoplasty. 

Vulvoplasty – Minimal depth Vaginoplasty – SRS –  Vulvoplasty is the same idea as a vaginoplasty without the vaginal canal. This can be a popular option for asexual people or people who have no interest in penetration. The surgery itself is much less complicated as you don’t need to construct a vaginal canal, and the recovery will reflect that. Another big advantage is not needing to dilate. As well as being able to bypass genital hair removal. Surgeons report about 10-15% of their patients requesting this over the traditional vaginoplasty, with growing numbers. This can also be an amazing option for patients at higher risks due to heart issues or age issues who could have problems being under anesthesia for long periods. The price range for a Vulvoplasty can be the same as vaginoplasty however in some cases it can be 20-25% cheaper. It all depends on which surgeon you choose. 

Breast augmentation – known as augmentation mammoplasty – Is the surgical increase of breast size. Breast augmentation is a widely available procedure, unlike many others on this list. The price can range from 5,000 – 10,000 USD. There are many different options, including saline and silicone implants, and where the implant is going to go, such as under the muscle or over it. 175 cc is about one cup size, so if you wish to go from a “B” cup to a “D” cup, you would need about a 350 cc implant. The most common sizes being 350-400 cc. A full recovery is about 6 weeks, but it is common for women to report feeling fine after about a week. Therapist notes or doctor’s notes are not commonly needed for this procedure.

Facial Feminization Surgery (FFS) – Facial feminization surgery is the surgical change of the face to make it more feminine. This can include but is not limited to rhinoplasty, trachea shave, hair transplant, forehead work, and many others. Some will choose many procedures, while others might choose only 1 or 2. FFS is unique for each patient, making price fluctuate; anywhere from 20,000 – 50,000 USD is common. Hormones will not change the skeleton structure of you unless you take them at a very young age. For some who have very prominent masculine features on their face, which could be causing them dysphoria, facial feminization surgery is the obvious answer.

Recovery time can also be very much dependent on what you are having done, but usually, you need around 2 weeks of full-time recovery. Around 4-6 weeks is about the time that people start to get back into daily life. The swelling will continue for many months. For FFS and other major surgeries, post-surgery depression can be a commonality. You will more than likely look really rough for the first week. This can be really worrying for a person having the surgery, especially if they expected that they would look amazing when they wake up. It is common for surgeons to require one or two therapists or doctor’s notes, but this is not always the case. In short, Facial feminization surgery is a medically necessary surgery for some trans women and can have life-altering effects.

Voice feminization surgery – VFS – Voice feminization surgery or vocal feminization surgery is the feminization of the voice through surgical means. This usually entails the shorting and raising of the vocal cords to be more in line with cis women. Some amazing results can be achieved from this procedure; however, most surgeons think it should be taken as a last resort after vocal training has been done. This surgery cost can be anywhere from $5,000 – 10,000 USD. The recovery is 2-4 weeks of no talking. You can usually start talking again on a restricted amount around the 6 weeks to the 3-month range. It can take months for you to get back to where you were before surgery. As the vocal cords start to get settled down, your pitch will start to rise. It is common for you to need a therapist note; however, it depends on the surgeon. Dr. Thomas, who offers the surgery in Oregon, has great information on his website, linked below:

https://www.voicedoctor.net/Surgery/Pitch/Feminization-Laryngoplasty

Image Credits;

Soul Source GRS Vaginal Dilators – Large Set

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