Bottom Surgery

Bottom Surgery

For female-to-male transgender individuals seeking “bottom surgery” as part of their gender affirming process, phalloplasty is one of the primary surgical options. Methods for phalloplasty include radial forearm and anterolateral thigh flaps.

The choice of technique will depend on the your body build/physique and goals. We will discuss this with you at the time of your first consultation.

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Before Your Appointment

Before your appointment, we advise that you contact your insurance carrier to determine whether gender affirmation surgery is a covered benefit. After you have had your first appointment, we can contact them to obtain a pre-authorization prior to the surgery.

If you do not have coverage, we will provide you with an out-of-pocket cost estimate.

For those patients desiring removal of ovaries, you will consult separately with one of our gynecologists.

WPATH Standards of Care

The providers follow the WPATH Standards of Care, which require TWO letter from qualified mental health care professionals prior to the surgery.

Criteria for Phalloplasty in FTM Patients

  1. Persistent, well documented gender dysphoria;
  2. Capacity to make a fully informed decision and to consent for treatment;
  3. Age of majority in a given country*;
  4. If significant medical or mental health concerns are present, they must be well controlled;
  5. 12 continuous months of hormone therapy as appropriate to the patient’s gender goals;
  6. 12 continuous months of living in a gender role that is congruent with their gender identity.

Although not an explicit criteria, it is recommended that these patients also have regular visits with a mental health of other medical professional.

*for younger patients, follow WPATH guidelines for adolescents.