Supporters of colovaginoplasty state that this method is better than use of skin grafts for the reason that colon is already mucosal, whereas skin is not. One important consideration is that any trans man who develops vaginal bleeding after successfully ceasing menses on testosterone, must be evaluated by a gynecologist. This means that they are unable to bear children or menstruate until a uterus transplant is performed, and that they will need to remain on hormone therapy after their surgery to maintain female hormonal status. In a second surgery the excess skin is removed.
Hysterectomy and bilateral salpingo-oophorectomy[ edit ] Hysterectomy is the removal of the uterus. The incisions are strategically placed to look like natural skin closes in the vaginal lips. During his fellowship, Keith focused on microsurgery and breast reconstruction. Elijah Stephens Elijah Stephens knew something was different about him. If the cervix is removed, it is called a 'total hysterectomy. Not everyone with gender dysphoria chooses to undergo gender affirmation surgeries, but Stephens knew it was what he wanted. Research has shown that after surgery many patients are able to enjoy a satisfying sex life. Next, the dorsal nerve bundle, which gives the penis feeling, the glans or head and the urethra which carries urine are separated from the main shaft of the penis. It is then attached to the genitals with fine stitches. Mastectomy[ edit ] Many trans men seek bilateral mastectomy , also called "top surgery", the removal of the breasts and the shaping of a male contoured chest. It was difficult to explain to mental healthcare providers what he felt about his body. Stanislas Monstrey , one of the top gender affirmation surgeons in the world. Within the population of transgender men on hormone therapy, many patients are at significantly decreased risk due to prior oophorectomy removal of the ovaries. Keith recalled a patient he had last year who was affirming from female to male. He did not want to risk having complications afterward without knowledgeable healthcare professionals nearby. It has a shorter recovery time and can become erect on its own. See Male Chest Reconstruction. Phalloplasty is just one option for creating a penis, though. He was also required to provide letters from two independent psychiatric evaluations by professionals confirming he understood the complexities involved with the surgeries. Certain medical doctors perform the surgery in two steps. This avoids the larger scars of a traditional mastectomy, but the nipples may be larger and may not be in a perfectly male orientation on the chest wall. This feeling followed him through adulthood. Surgeon's requirements, procedures, and recommendations vary enormously in the days before and after, and the months following, these procedures. In a second surgery the excess skin is removed. However, the penis is small after a metoidioplasty, explained Keith.
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