FTM Bottom Surgery Types

FTM bottom surgery is an exciting step for patients, but there are so many options and possibilities that it can be hard to wade through the information. This blog provides a brief overview of the different types of FTM bottom surgeries, including the procedures offered at Restore Medical Center in Miami, as well as who are ideal candidates for the procedure and how patients can get started on the next step in their gender-affirming journey.

What Are the Different Options for FTM Bottom Surgery?

Transmasculine bottom surgery is a major step for many trans patients, and while it is a very personal decision, it’s important to be informed about your options so you can advocate for yourself throughout the process. There are many different ways to embody your gender, and as such, there are many ways to have bottom surgery. Common FTM bottom surgery types include:

• Hysterectomy
• Oophorectomy
• Vaginectomy

Restorative procedures that provide aesthetic and functional benefits include: 

• Phalloplasty
• Metaidoioplasty

Gender-Affirming Care at Restore Medical Center

Restore Medical Center is Miami’s only practice dedicated solely to gender-affirming care. Led by Dr. John L. Whitehead and Dr. Alain Ramirez, both board-certified physicians, experts in gender-affirming care, and members of the LGBTQIA+ community, Restore takes a comprehensive, patient-centered approach. Drs. Whitehead and Ramirez prioritize patient education and safety above all else, advocating for patients’ understanding and agency in their gender-affirming process, no matter what that looks like.

Restore offers hysterectomies, oophorectomies, and vaginectomies, but not phalloplasty or metoidioplasty. However, our team has strong relationships with other gender-affirming practices and physicians and can make referrals if needed.

How Does FTM Bottom Surgery Work?

FTM bottom surgery is customized to your needs and goals, and each type yields a different result. Many of these procedures can be combined or performed alone, depending on your desired outcome. 

FTM bottom surgery can be performed in stages, first with the removal of female reproductive organs, called extirpative procedures, including the uterus, cervix, vagina, and ovaries. There are other reconstructive procedures like phalloplasty and metoidioplasty. These have functional and aesthetic benefits, such as creating/enlarging the phallus and helping with functions like standing to urinate or facilitating penetrative sex.

We’ll break down what each option does and what results you can expect from each below.

Hysterectomy

A hysterectomy is the surgical removal of the uterus. It can be performed at the same time as the removal of the cervix (located at the bottom of the uterus). The procedure can be performed vaginally, laparoscopically, robot-assisted, or abdominally, and usually takes between one and three hours.

Physical Changes: Patients who undergo a hysterectomy will no longer menstruate and cannot become pregnant.

Oophorectomy

An oophorectomy is the surgical removal of the ovaries. This greatly reduces the production of estrogen and progesterone, as the ovaries are the primary producers of these hormones. This can be performed with a hysterectomy.

Physical Changes: The lack of estrogen and associated hormonal fluctuations can reduce gender dysphoria for some patients. Additionally, because estrogen levels drop so drastically, patients may be eligible for lower doses of testosterone, thereby reducing any side effects (from T) that patients may be experiencing.

Vaginectomy

Vaginectomy is the surgical removal of all or part of the vagina and can be performed vaginally or laparoscopically. The procedure can involve the removal of the vaginal mucosa (lining), closing the vaginal canal, and creating a smooth perineum. 

Physical Changes: A vaginectomy can improve feelings of gender dysphoria. Patients also cannot engage in penetrative sex if the vaginal canal is closed.

Am I a Candidate for FTM Bottom Surgery?

Restore Medical follows the guidelines set by the World Professional Association for Transgender Health (WPATH) Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People. These guidelines state that patients seeking FTM bottom surgery should meet the following criteria: 

• Have persistent and documented gender dysphoria
• Are age 18 or older (exceptions are possible)
• Have the capacity to make fully informed decisions and can consent to the treatment
• Have been cleared for gender reassignment surgery by two licensed therapists who specialize in gender transition
• Significant or chronic medical concerns are 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

Additionally, surgical candidates should: 

• Be nonsmokers or willing to quit
• Be in good overall health
• Have a good support system to help them through surgery and recovery

Bottom surgery is a major surgical procedure that isn’t taken lightly, and it requires a moderate amount of time and effort to get through the recovery process. However, nothing is more important than your internal emotional and mental wellness, and patients who undergo their procedures often remark that the only thing they regret is not doing it sooner.

Want to Learn More About FTM Bottom Surgery in Miami, FL?

Don’t put your life on hold any longer: Call Restore Medical Center today at (305) 865-2000, or complete the contact form to get started. Our team is ready to schedule a consultation, answer any questions—none too small—and support you in any way you need.