FTM Bottom Surgery: Can You Feel It?
Patients considering bottom surgery naturally have a lot of questions, with one standing out: What will it feel like down there? This blog answers that question and more, discussing the different types of FTM bottom surgery and how to take the next step in your gender-affirming journey.
What Are FTM Bottom Surgery Options?
Transmasculine patients who choose to undergo FTM (female-to-male) bottom surgery have a number of options for their procedure, each with varied functional and aesthetic results. While this is a very personal decision and every patient has different needs, goals, and concerns, it’s helpful to understand your options ahead of time.
Options include:
- Hysterectomy: The removal of the uterus
- Oophorectomy: The removal of the ovaries
- Vaginectomy: The removal or alteration of the vagina and vaginal canal
- Phalloplasty: Surgery to create a penis
- Metoidioplasty: Surgery to create a penis out of the clitoral tissue
These procedures are all important for gender affirmation and improving body dysmorphia, and they all provide different physical and aesthetic results. For example, hysterectomy, oophorectomy, and vaginectomy address the female sex organs directly and aim to remove these organs to influence hormones, improve a person’s gender euphoria, and act as initial steps before other procedures, like phalloplasty.
The choice comes down to you and your gender identity: Do you envision yourself with a penis? Or will the removal of the uterus and cessation of menstruation improve your self-perceptions?
What Sensations Can You Feel After FTM Bottom Surgery?
When it comes to sensation, each procedure has a different outcome.
Vaginectomy, Hysterectomy, and Oophorectomy
These procedures do not directly affect sexual sensation, as they deal with the removal of the uterus and ovaries, respectively. Vaginectomy, too, preserves the clitoris to ensure the patient has normal sexual sensation and arousal.
These are often required precursors to the other types of gender-affirming procedures that create a phallus.
Metoidioplasty
This procedure gives the patient a more prominent phallus by moving the erectile tissue within the clitoris to a more forward position. The clitoris is an erectile body and can become engorged during arousal just like a penis. During metoidioplasty, your surgeon will release the erectile tissue from its surrounding ligaments, allowing it to be more pronounced. This procedure is often performed after testosterone therapy has caused the erectile tissue to grow larger.
If the patient would like to be able to urinate standing up, the urethra can be extended up through the phallus in a separate surgery, typically performed during a vaginectomy. However, metoidioplasty does not create a phallus prominent enough for penetrative sex.
Metoidioplasty allows for erogenous sensation, erections, orgasm, and the ability to masturbate.
Phalloplasty
Phalloplasty is a multi-stage gender-affirming procedure that creates a penis using existing genital tissue and tissue from another part of the body, such as the forearm, thigh, or groin. Sensation depends on the type of phalloplasty. Additionally, there are different types of sensations possible with these procedures: tactile, which is touch, so you can feel that someone is tapping the tissue, and erogenous, which is a heightened, sexual sensation associated with sex organs like the clitoris or penis.
Depending on the type of phalloplasty you undergo, you can expect nerve regeneration and re-sensation as early as three weeks after surgery, though this varies from patient to patient. Some patients might feel tingling sensations as they heal, or certain parts of the penis might have sensation while others don’t.
Whichever procedure you choose, you will end up with either tactile or erogenous sensation, and they will be felt equally along the entire penis. Certain phalloplasties can involve an additional microsurgery that attaches a nerve from the clitoris to the head of the new penis, resulting in a focused erogenous area.
FTM Bottom Surgery: What’s Best For Me?
These techniques are incredibly advanced and complex, and not every type of gender-affirming surgery will result in full sensation. However, gender-affirming surgeons have an express interest in helping their patients live their best possible lives, including healthy, satisfying lives in relation to sex. You have plenty of decisions to make, but you don’t have to do it alone.
Scheduling a consultation with an experienced surgeon who specializes in gender-affirming care is the next step toward your future. They will listen to your goals and vision for your body and self, and then discuss your options for getting there.
Learn More About Transmasculine Bottom Surgery in Miami, FL
Restore Medical Center is Miami’s only practice dedicated solely to gender-affirming care. Board-certified physicians and experts in gender-affirming care, and members of the LGBTQIA+ community, Drs. Whitehead and Ramirez are ready to help you choose the best path for your needs. Call Restore Medical Center today at (305) 865-2000 or complete the contact form to request a private consultation.