Metoidioplasty uses a testosterone-enlarged clitoris to form a penis. This gender affirmation surgery can be done with or without lengthening the urethra.
A metoidioplasty is a type of gender affirmation surgery, also referred to as a “bottom surgery” or a “meta.” The procedure uses the tissue from your clitoris to create a neophallus, literally a “new penis." Before the surgery, you should be on hormonal substitution therapy for at least one year. Testosterone will increase the size of your clitoris.
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A metoidioplasty is a surgery sometimes requested by people assigned female at birth. This surgery helps to align their physical bodies with who they really are. A metoidioplasty treats gender dysphoria.
The goals of surgeons who do gender affirmation surgeries are to provide a penis of suitable length, natural-looking genitalia and the ability to urinate while standing up.
One survey estimated that 2% of transmen in the U.S. have had metoidioplasty and about 25% would like to have it in the future. However, there has traditionally been some difficulty in reporting accurate figures regarding the transgender and non-binary populations. This is due in part to different and changing terminology and also to the fact that data has not always been collected. Numbers do indicate that the number of gender-affirming surgeries being done is increasing and will continue to rise.
Before your surgery, you’ll probably do these things:
During a metoidioplasty, your surgeon will use the tissue from an enlarged clitoris to form a micropenis. (This refers to a penis that is less than 7 centimeters or about 2.57 inches long.)
Depending on the type of metoidioplasty you have, your surgeon may:
You may want to have other surgeries or additional changes during this surgery. These choices include whether or not your urethra is made longer, whether or not you have a scrotoplasty (to create a scrotum) and or a vaginectomy (to close the vagina, with or without a hysterectomy and oophorectomy. You may want to add testicular prostheses (testicular implants).
After a metoidioplasty, you’ll need time to heal. Sometimes the surgery is done in several steps and subsequent surgeries take place two to four months after your first one.
The advantages of metoidoplasty include:
Every type of procedure has risks, like infection. The complications of metoidioplasty include:
Another complication is that you may be dissatisfied with the results of the surgery. Some people who have had a metoidioplasty go on to choose another male genital surgery called a phalloplasty.
You should be able to walk and do light activity after about a week and resume normal activities after about six weeks.
If you’ve had a metoidioplasty, you should always follow the recommendations made by your surgeon regarding the schedule of visits and recuperation. Your healthcare team is always ready to take questions, so don’t hesitate to call with your concerns.
However, you should call your provider or seek emergency care if you:
A metoidioplasty uses existing genitalia — clitoris and vaginal tissue — to create a penis. The new penis is more of a micropenis. The sensation you had in the area isn’t lost. You can have an erection after a metoidioplasty.
A phalloplasty uses larger flaps of skin and muscle from other places in your body, such as your forearm, your thigh or your back, to create the penis. The penis formed in a phalloplasty is likely to be larger and more natural-looking, but you’ll need additional procedures to be able to have an erection. Some people may decide to have a phalloplasty after a metoidioplasty.
A note from Cleveland Clinic
A metoidioplasty is a surgery that creates a penis out of genital tissue that is already there. If you’ve decided to have a metoidioplasty, you’ll have already done a lot of research. Work with your healthcare providers to make sure you understand all of your options and possible complications. Discuss your expectations. You may need or want further surgery.
Last reviewed by a Cleveland Clinic medical professional on 08/18/2021.
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