Transmasculine Bottom Surgery

Deciding to undergo transmasculine bottom surgery, also known as female-to-male (FTM) bottom surgery, is a highly personal decision in a patient’s gender-affirmation journey. While our highly trained, experienced, and skilled surgeon Dr. Whitehead will guide you through this life-changing process, you must be well informed. Understanding the intricacies of the process and what to expect will help you ask the right questions and feel confident about the decisions you make as you prepare–both mentally and physically–for the next step in your transformation.

What Is Transmasculine Bottom Surgery?

Ovaries are responsible for hormone and egg production. The uterus lies within the abdominal cavity next to the ovaries and supports a growing embryo. The vagina provides a passageway for childbirth, monthly products of menstruation, and sexual intercourse. Transmasculine patients may decide to remove one or more of these organs, depending on their personal goals. The organs can be removed through a variety of techniques, including traditional open, laparoscopic, or robotic; the specific method used will determine if the procedure requires overnight hospital admission or not. Though we do not perform phalloplasty, this procedure is a necessary first step if you are going to go on to have phalloplasty in the future.

Am I a Candidate for Transmasculine Bottom Surgery?

According to the World Professional Association for Transgender Health (WPATH) Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People, candidates for transmasculine bottom surgery should meet the following criteria:

• Have persistent and well-documented gender dysphoria
• Be 18 years or older (exceptions can be made on a case-by-case basis)
• Have the capacity to make a fully informed decision and consent to treatment
• Have been cleared for gender reassignment surgery by two licensed therapists who specialize in gender transition
• Any significant or chronic medical concerns must be well controlled
• Have at least 12 continuous months of hormone therapy
• Have at least 12 continuous months of living in the gender role congruent with their gender identity

Patients should also be nonsmokers in good overall health who have a support system of family, friends, or trusted adults to help them through surgery and recovery. This support system is not just important, it’s crucial. It can provide emotional support, help with daily tasks during recovery, and ensure the patient’s overall well-being, giving you the reassurance and support you need during this journey.

What Types of Transmasculine Bottom Surgery Are Available?

Each patient’s surgical journey is unique and deeply personal. Dr. Whitehead approaches each patient with a high level of personalization, ensuring you receive the most natural, true-to-you results.

The exact surgical approach for your procedure, such as incision types, will depend on your health and anatomy. The procedures involved in transmasculine bottom surgery include:

Hysterectomy

A hysterectomy is the surgical removal of your uterus. After a hysterectomy, you will no longer menstruate or be able to get pregnant. It often also includes the removal of your cervix. There are several methods used to perform a hysterectomy surgery, including vaginal, laparoscopic, robotic-assisted, and abdominal. The technique used for your hysterectomy will depend on your specific anatomy and Dr. Whitehead’s expertise. Hysterectomy surgery typically takes one to three hours, and recovery times vary according to the surgical technique used.

Oophorectomy

An oophorectomy is the surgical removal of your ovaries. There are a variety of types of oophorectomy surgery, including removal of the ovaries only and removal of the ovaries, fallopian tubes, uterus, cervix, and vagina (or any combination of those). The type of oophorectomy you choose will depend on your overall health needs and desired outcome. Oophorectomy can be performed in several ways, including via vaginal removal, laparoscopic surgery, or a laparotomy. Each type of oophorectomy has its own benefits and risks, and Dr. Whitehead will discuss these with you during your consultation.

Vaginectomy

Vaginectomy is the surgical removal of all or part of your vagina. It is often used as part of treatment for vaginal cancer (which is extremely rare), but more frequently, it is used as part of transmasculine bottom surgery. You may decide to get a partial or total vaginectomy, and it can be performed either vaginally or laparoscopically.

The above surgeries can be done alone or in combination, depending on what you and Dr. Whitehead decide is in your best interest. Your recovery time will vary according to the type of surgery and the technique used.

While many transmasculine bottom surgeries involve phalloplasty or metoidioplasty, Restore Medical Center does not offer those services. Usually, the surgeon that performs phalloplasty or metoidioplasty does not perform the surgeries that we perform.

What Surgical Techniques Are Used in Transmasculine Bottom Surgery?

Transmasculine bottom surgery can be accomplished using the traditional open manner, laparoscopically, or robotically. Open surgery is the least costly; however, it is also the most invasive. This method can sometimes be associated with more postoperative pain and longer healing times due to larger incisions. It also usually requires an overnight stay in the hospital.

Laparoscopic surgery employs a small camera to facilitate surgery. It has the advantage of quicker recovery and fewer side effects from pain medications as less is typically needed. This is generally performed as an outpatient procedure.

Robotic surgery has advantages similar to laparoscopic surgery and is minimally invasive when compared to open surgery. It offers Dr. Whitehead the advantage of a magnified 3-D view of the surgical field and can help deliver superior, safer results in complex cases.

How Does One Prepare For a Transmasculine Bottom Surgery Procedure?

At Restore Medical Center, our primary focus is YOU. We are deeply committed to ensuring that each of our gender-affirming patients can access the surgeries they need to feel more like the person they are inside. We also want to ensure that each patient has all the information and details necessary to make a well-informed decision about their surgery. You are our priority, and we are here to support you every step of the way.

During your private one-on-one consultation, you can ask any and all questions about transmasculine bottom surgery. Dr. Whitehead is sensitive and understanding of your situation and will work closely with you to create the best plan for your unique situation.

In accordance with the WPATH Standards of Care, each of our patients is recommended to meet with two gender therapists to help ensure that surgery is an appropriate treatment for the patient’s dysphoria. Restore Medical Center will work with you to help facilitate these meetings so that you may get to surgery sooner rather than later if that will help alleviate your gender dysphoria.

Our surgery team will provide you with detailed pre-surgical instructions in the weeks and days leading up to your procedure. If you have any questions or concerns regarding your surgery at any time, please do not hesitate to call our office or Dr. Whitehead directly. We are here to support you every step of the way.

Are There Complications or Risks Involved in Transmasculine Bottom Surgery?

Like all surgery, transmasculine bottom surgery does have some risk of complications. These include:

• Heavy bleeding
• Blood clots
• Infection
• Damage to surrounding organs

Dr. Whitehead is expertly trained in performing hysterectomies, oophorectomies, and vaginectomies and is meticulous about taking the necessary steps to ensure each patient’s utmost safety. If you experience heavy bleeding, unusual discharge, severe pain, or have trouble urinating after your surgery, call our office immediately.

FAQs About Transmasculine Bottom Surgery

When can I return to work after transmasculine bottom surgery?

Your return to work will depend on how you feel, the level of exertion required at your job, and the type of procedure you have. Most patients return to work within four to eight weeks after surgery.

You will be in continued contact with Dr. Whitehead as you recover, and your postoperative instructions will be individualized to your specific surgery and needs.

When can I exercise and work out again after transmasculine bottom surgery?

While walking is encouraged as you heal, you should still take it easy and gradually increase the distance and intensity of your walks. You should be able to resume most other exercises four to six weeks after surgery, but you may need to wait longer before performing more strenuous workouts. Make sure Dr. Whitehead clears you before returning to your regular exercise routine.

When will I be able to resume having sex after transmasculine bottom surgery?

You should refrain from having sex until your surgical wound has fully healed, which typically takes four to six weeks. If you are comfortable having sex at that time, it is usually safe to do so. Keep in mind that you may experience an initial lack of interest in sex after your transmasculine bottom surgery. Don’t worry: this is normal, and your sex drive should return once you have fully recovered.

You will be provided with detailed postoperative instructions upon completion of your procedure. If you have any questions or concerns after surgery, please contact our practice immediately.

How old do I have to be to get transmasculine bottom surgery?

While there are no specific age limits for transmasculine bottom surgery, WPATH recommends that transmasculine bottom surgery patients reach the age of majority (age 18) before undergoing FTM surgery.

How much does transmasculine bottom surgery cost?

The cost of transmasculine bottom surgery varies according to what procedures you undergo and the methods used to perform them. During your consultation, Dr. Whitehead will discuss a treatment plan and give you an accurate cost estimate for your transmasculine bottom surgery.

Does insurance cover transmasculine bottom surgery?

Restore Medical Center is proud to be officially contracted with Cigna and Aetna insurance companies to cover your transmasculine bottom surgery. We also work with several other commercial insurance companies to ensure we can provide all our patients with full-service gender-affirming care. Our helpful and knowledgeable staff will help you navigate the insurance process, from requirements to approval and anything in between. For more information on insurance coverage for your FTM bottom surgery, visit our informational page here.

How Can I Learn More About Transmasculine Bottom Surgery in North Florida?

If you want to explore your options for transmasculine bottom surgery, the professional, compassionate doctors at Restore Medical Center would love to speak with you during a private one-on-one consultation at our Miami area practice. As advocates in the LGBTQ+ community, our mission and passion is to help each trans man or woman achieve their true selves through beautifully personalized results. To schedule an appointment with one of our board-certified experts, call us today at 305.865.2000 or fill out our online contact form.