Gender transition is a process through which transgender individuals seek to align their physical and social appearance with their gender identity. This means that, in most cases, trans women – individuals assigned male at birth – seek a more feminine appearance, while trans men – individuals assigned female at birth – seek a more masculine appearance.
However, gender identity is not exclusively based binary; for example, there are non-binary trans individuals who do not identify within the roles described by the prevailing social binarism – that is, they do not identify strictly as male or female.
The transition process may include a change of name, pronouns, physical appearance and clothing style, among other aspects.
For many transgender people who wish to align their bodies with masculine identity, surgery plays a fundamental role in achieving greater coherence between their bodies and gender identity. However, this is not the case for all trans people.
Transgender FTM surgery – Female to Male – or Gender affirming surgery for trans men consists of a set of medical procedures designed to adapt the anatomy of a person assigned female at birth to their male gender identity. This process, based on the self-determination and well-being of the individual, falls within the field of transgender health and aims to provide coherence between gender identity and the physical expression of the body.
Gender affirming surgery for Trans Men
Gender-affirming surgery encompasses various procedures, including both genital surgery and techniques aimed at modifying facial and body features to achieve an appearance more aligned with a trans man’s gender identity.These procedures may include:
- Mastectomy: This surgery removes breast glandular tissue while preserving the areola and nipple, adapting their size and position. The result is a flat thorax with a more masculine appearance and proportion.
- Hysterectomy: It is a gender-affirming procedure to remove the uterus and usually the ovaries as well. Removing these organs reduces the production of estrogen and other female hormones. This surgery is as well the previous step for a future phalloplasty or metoidioplasty.
- Phalloplasty: Phalloplasty is a genital surgery that reconstructs a functional and sensitive neophallus, allowing for standing urination and erogenous sensitivity. This surgery is often combined with the placement of testicular prostheses, to give a male physical characteristics to the genitals.
- Metoidioplasty: This is a surgical technique that creates a micropenis from the hormonally enlarged clitoris. This organ has significant erogenous sensitivity, but penetration is not possible during sexual intercourse.
- Body Surgery: It is a set of procedures designed to masculinize the body contour, reshaping the silhouette for a more defined and muscular appearance. This includes liposuction in areas such as the flanks, thighs, and buttocks to reduce fat.
- Other Surgeries: There are additional procedures to achieve a more masculine appearance. Some of them are: vaginectomy, testicular implants, post-phalloplasty micropigmentation, and voice masculinization treatments.
At IM GENDER, we have been specialized in these types of surgeries for over 25 years. Not only do we have a team of medical specialists, but we also have a compassionate, experienced team that provides ongoing support throughout the process to ensure the well-being of each patient.
It is important to remember that the decision to undergo gender reassignment surgery is personal and unique to each individual. Not all transgender people feel the need to undergo surgery to affirm their gender identity.
Who Are These Gender Affirming Surgeries For?
Surgeries such as bilateral subcutaneous mastectomy, phalloplasty, and metoidioplasty – commonly known as masculinization surgeries – are part of gender-affirming or gender reassignment surgery, mainly aimed for trans men. However, they can also be an option for non-binary individuals seeking a more masculine appearance.
The main motivation for undergoing surgery is often the need to align one’s body with their gender identity. Having a physical appearance consistent with one’s gender can positively impact self-esteem and personal image.
Therefore, the results of surgery often lead to significant improvements in the psychological and emotional well-being of trans individuals.
However, it is important to recognize that while some transgender individuals choose surgical procedures, others feel satisfied and complete with their physical appearance without the need for surgery, hormone therapy, or other procedures.
Considerations Before Female to Male Surgery for Trans Men
Choosing gender-affirming surgeries requires preparation. The most important step is to have a consultation with the specialist surgeon who will perform the transgender FTM surgery. You will be able to express your doubts, concerns, and anything that causes you anxiety about the procedure to the medical team. If you need an appointment to clarify any remaining questions, don’t hesitate to request it.
At IM GENDER, our specialists will also inform you about the risks and benefits of the transgender female to male surgery you seek, whether it is advisable in your case, as well as the procedure and recovery process.
They will perform physical exams, review your medical history, conduct analyses and other tests to assess your health status and the suitability of the surgery. They will also evaluate your goals and expectations to ensure they are realistic and appropriate.
Currently, in Spain, a psychological report is not required, nor is it necessary to discontinue hormone therapy before surgery. However, your doctor will assess your motivations and health status to create a personalized plan.
Additionally, you will be advised on how to prepare for gender-affirming surgery: diet, alcohol, tobacco, other substances, physical activities, and medication. All this is to ensure your health throughout the procedure.
Postoperative Care in Female to Male Surgery
It is crucial to follow the medical team’s postoperative recommendations after FTM surgery or reassignment surgery for trans men to achieve a good recovery and optimal results. Each surgery will require different recovery times and postoperative care. For example:
- Bilateral Subcutaneous Mastectomy:
You may have drains in place for the first 24-48 hours to remove fluids and prevent hematomas. Afterwards, you will need to wear a compression garment, band, or vest for several days. - Phalloplasty:
Full recovery may take several weeks, especially in the donor area. This is usually the arm, where skin is taken to create a neopenis. You will likely have a urinary catheter for at least the first three weeks.
In general, gender-affirming surgeries for trans men require rest during the initial days, avoiding heavy lifting or exertion, following prescribed medications to manage discomfort and prevent infections, and regular follow-up with your medical team.
You may also need to make lifestyle and daily activity adjustments during the recovery period. Moreover, beyond physical care, emotional support plays a key role in facing this process with a positive outlook.
What Results to Expect after Female to Male Surgery?
Expectations regarding female to male surgery for trans men may vary depending on the patient and the type of procedure performed.
In general, these surgeries aim to masculinize certain physical characteristics to adapt them to the individual’s gender identity. After recovery, the results from procedures such as mastectomy and other body surgeries are usually quickly visible, with a more masculine chest and contour.
In the case of phalloplasty and metoidioplasty, a phallic appearance is achieved. Although it is important to note that due to the complexity of these procedures, additional surgeries or procedures may be required to perfect the aesthetics.
It is important to maintain realistic expectations. These surgeries can achieve significant transformations but there are always anatomical and medical limitations.
Open communication with the surgeon, supported by the experience and professionalism of the IM GENDER team, is essential for understanding these limitations and managing expectation.
If you have any further questions about gender affirmation surgery for trans men, make an appointment with the IM GENDER team and we will inform you.
