A transgender woman in a hospital gown having a conversation with a doctor, a transgender man.
A transgender woman in a hospital gown having a conversation with a doctor, a transgender man.
A transgender woman in a hospital gown having a conversation with a doctor, a transgender man.

Gender Affirmation Surgeries

Gender Affirmation Surgeries

Surgeries are not required for gender affirmation, but many patients choose to undergo one or more surgical procedures. Talk with your doctor to discuss what surgical options may be right for you.

What You Need to Know: Gender Affirmation Surgeries

Gender affirmation surgeries are typically performed in stages.

  • Recovery time for gender affirmation surgeries can vary according to the procedure.
  • To proceed with gender affirmation surgery, you will need to postpone hormone therapy for two to three weeks prior to surgery.
  • Other procedures, such as laser hair removal, may be required prior to surgery.

Gender Affirmation Surgeries

The following is an overview of gender affirmation surgeries.

  • Penile construction (phalloplasty/metoidioplasty): This surgical procedure can include removal of the vagina (vaginectomy), reconstruction of the urethra and penile reconstruction. Surgeons may use either vaginal tissue or tissue from another part of the body to construct the penis.
  • Top surgery (mastectomy or augmentation): Bilateral mastectomy is the removal of the breasts, shaping of a contoured male chest, and refinement of the nipple and areola. Breast augmentation is the enlargement of the breasts using breast implants.
  • Vaginal construction (vaginoplasty): This surgical procedure is a multistage process during which surgeons may remove the penis (penectomy) and the testes (orchiectomy), if still present, and use tissues from the penis to construct the vagina, the clitoris (clitoroplasty) and the labia (labiaplasty).
  • Facial feminization or masculinization: In cases where hormone therapy is not enough to feminize or masculinize the face, surgery may help. 
    • Facial feminization surgery includes a variety of procedures, like reshaping the nose; brow lift (or forehead lift); chin, cheek and jaw reshaping; Adam’s apple reduction; lip augmentation; hairline restoration; and earlobe reduction. 
    • Facial masculinization surgery includes a series of procedures, such as forehead lengthening and augmentation; cheek augmentation; reshaping the nose and chin; jaw augmentation; and thyroid cartilage enhancement to construct an Adam’s apple.
  • Hysterectomy: This surgical procedure includes the removal of the uterus and ovaries (oophorectomy). There are options for oocyte storage and fertility preservation that you may want to discuss with your doctor.

Recovery After Gender Affirmation Surgeries

Recovery time from a gender affirmation surgery or procedure varies, depending on the procedure. Talk to your doctor about what you can expect.


Paula Neira

Caring for Transgender Patients

Fearing discrimination and hostility, transgender people are often reluctant to seek care. Discover how Paula Neira, clinical program director of the Johns Hopkins Center for Transgender Health, is working to ensure that all patients — regardless of gender identity — are treated with dignity and respect.

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