Gender transition is a process whereby transgender people seek to align their physical and social appearance with their gender identity. This means that people who were identified as male at birth may seek a more feminine (male to female) appearance, or that people who were identified as female at birth may wish to move towards more masculine (female to male) features. There are also non-binary trans people, who are those who do not identify with any of the roles described by the prevailing social binarism, that is to say they do not identify as either a woman or a man. 

Transition may include a change in name, pronoun, physical appearance and dress style, among other things. For some transgender people, gender affirmation surgery is an important step towards achieving greater consistency between their body and their gender identity. In this article, we tell you in detail about female to male gender reassignment surgery (known as female to male surgery or masculinisation surgery), exploring various procedures and what they entail.


Female to male transgender surgery

For many transgender people seeking to align their bodies with their male identity, surgery plays a key role. Trans male gender affirmation surgery (female to male surgery) is a set of medical procedures designed to match the anatomy of a person assigned female at birth to their male gender identity. This process, which is based on the individual’s self-determination and well-being, falls within the scope of transgender health and primarily aims to provide consistency between gender identity and physical body expression.

The different techniques of gender confirmation surgery can encompass a variety of procedures, each designed to modify different aspects of the anatomy in order to achieve an appearance that is more in line with the trans man’s gender identity. These procedures may include:

  • Mastectomy: This surgery involves removing the glandular breast tissue while preserving the areola and nipple, and adapting their size and position to a more masculine chest. The result is a flat torso with a more masculine appearance and proportion.
  • Hysterectomy: This surgery involves removing the internal genitalia such as the uterus and ovaries. Removing these organs reduces the production of oestrogen and other female hormones and can also prepare the area for possible phalloplasty or metoidioplasty at a later date. 
  • Phalloplasty: phalloplasty is genital surgery involving reconstructing a functional and sensitive neopenis which will enable bipedal urination (peeing while standing up) and will have erogenous sensitivity. This surgery is often accompanied by an operation to insert testicular prostheses, which together with the phalloplasty give the genitalia a masculine appearance.
  • Metoidioplasty: This is a surgical technique that involves creating a micropenis from the clitoris. This organ has high erogenous sensitivity, but does not allow for sexual penetration.
  • Body surgery: These are operations that aim to masculinise the contour of the body. This surgery involves shaping the figure to achieve a more defined and muscular appearance.
  • Other surgery: There are other procedures for achieving a more masculine appearance, including vaginectomy, testicular implants and post-phalloplasty micropigmentation, as well as voice masculinisation procedures.

At IM GENDER we have been specialists in all these types of surgery for 25 years. Not only do we have a medical team specialising in each area, but we also offer a team of experienced and sensitive staff, as well as psychological support to ensure the well-being of each patient. Our commitment is to accompany you every step of the way.

It is important to remember that the decision to undergo genital reassignment surgery is a personal one that is unique to each individual. It is essential to note that not all transgender people feel the need to opt for surgical procedures to validate their gender identity.

Who is this surgery aimed at?

Female to male gender affirmation surgery, also known as masculinisation surgery, is primarily aimed at transgender people who were assigned female at birth but who identify as male. It may also be an option for non-binary individuals seeking to align their bodies with a more masculine appearance.

The most common reason why someone chooses to undergo this surgery is a need to align their body with their gender identity. This alignment often leads to a marked improvement in psychological and emotional well-being. In addition, having a physical appearance that is consistent with internal self-perception can have a positive impact on self-esteem and self-image. However, it is important to note that while some transgender people opt for surgical procedures, others find satisfaction and fulfilment with their physical appearance without undergoing operations. 


Things to consider before surgery and how to prepare

Opting for certain gender surgeries is a decision that requires a degree of preparation. The most important thing is that you have a consultation with the plastic surgeon who will perform the surgery, and that you express any doubts, concerns or anything that causes you anxiety about the procedure, so that the medical team can address these issues. Don’t leave anything out, and if you need another consultation to finish clarifying something, don’t hesitate to ask for it.

The IM GENDER doctor will also inform you about the risks and benefits of your desired gender surgery, whether it is advisable in your case, and the procedure and recovery process. In addition, you will be given physical examinations, your medical history will be assessed, and you will undergo analyses and other tests to evaluate your state of health and the suitability of this surgery. There will also be an assessment of both your goals and your expectations to ensure they are realistic and appropriate.

Currently, there is no requirement in Spain for a psychological report or to stop hormone therapy before surgery. However, your doctor will assess your motivations and state of health to make a personalised plan for you. In addition, they will advise you on how to prepare for surgery in relation to diet, consumption of alcohol, tobacco and other substances, certain activities and medication. All of this is to ensure you remain healthy throughout the procedure.


The postoperative phase of female to male surgery

It is very important to follow the recommendations of the medical team after gender reassignment surgery (female to male transgender operation) in order to achieve a good recovery and optimal results. Each surgery will require a different recovery time and a different type of postoperative period. For example, in the case of bilateral subcutaneous mastectomy, you may need to wear drains for the first 24-48 hours to remove fluids and prevent bruising. Afterwards, you will need to wear a compression garment, bandage or vest for a few days. In the case of phalloplasty, full recovery can take several weeks, especially at the donor site (usually the arm), and you will probably need to wear a urinary catheter for at least three weeks.

In general, gender affirmation surgery for trans men requires rest for the first few days, avoiding lifting weight or exertion, following prescribed medication to control discomfort and prevent infection, and regular follow-ups with your medical team. You may also need to make some adjustments to your lifestyle and daily activities during the recovery process. In addition, besides physical care, emotional support plays a key role in facing this process with a positive outlook.


What results can be expected?

Expectations regarding female to male surgery may vary depending on the patient and the type of procedure performed. In general, these operations aim to masculinise certain physical features with the intention of adapting them to the gender identity of the trans person requesting the procedure.

Following recovery, the results of procedures such as mastectomy and body surgery are often quickly apparent, with the patient displaying a more masculine chest and contour. In the case of phalloplasty and metoidioplasty, a phallic appearance is achieved, but it is important to bear in mind that due to the complexity of these procedures additional operations or procedures may be required to perfect the aesthetic appearance.

It is important to have realistic expectations. Although this surgery can achieve significant transformations, there are always anatomical and medical limitations. Open communication with the surgeon, underpinned by the experience and professionalism of the IM GENDER team, is essential in order to understand these limitations and adjust expectations accordingly.


If you have any further questions about what female to male surgery involves, make an appointment with the IM GENDER team and we will inform you.