If you’re equipped with a clit and some labia and you’d like a penis (with or without testicles), you’re looking at either a phalloplasty or metoidioplasty. The procedures have different advantages and disadvantages that you’ll want to consider before making a decision.
Phalloplasty involves the construction of a penis from grafted tissue taken from elsewhere on the body — one option is the lower abdomen. The surgeon can create a circumcised or uncircumcised johnson for you, complete with testicles if desired. To construct testicles, the surgeon recycles your labia (and can add implants as well). You’ll retain sensation in your clitoris, and you should be able to have penetrative intercourse (some surgeons add a prosthesis that will allow you to get hard, but prostheses can fail). If you want to be able to stand to urinate, it will require a lengthy extension of your urethra, which comes with a lot of risks including stenosis (becoming fully or partially blocked) or fistula (springing a leak). Because of these issues, some surgeons won’t do it.
This procedure comes with risks. You can experience infection and scarring at the donor site, and the tissue on your penis could develop necrosis (die) even if you’ve cared for it as directed. The ultimate shape and size could be different from expected, and there will be some scarring. Depending on the surgeon and the procedures used, you may need multiple surgeries, and it’s possible you will have to return for revisions to address complications. This procedure is also quite expensive, and not always covered by insurance providers.
Metoidioplasty, also known as clitoral release, involves “elevating” your clitoris and may include constructing a new urethra along with it. While your resulting penis can allow you to stand to pee and it will be highly sensitive, it will also be quite small – around two inches or so. Complications can include scarring, infection, loss of sensation or excessive sensation, narrowing of your vaginal opening (which may not be a concern for you, depending on whether you want to be able to have vaginal penetrative intercourse), or problems with your constructed urethra similar to those discussed above. As with phalloplasty, your doctor can hook you up with a set of testicles if desired.
This section is part of a larger piece, Trans Summer School: The Wide World of Surgical Transition. To read the whole piece or another section, click here!
