Female-to-male (FTM) gender reassignment surgery

Transition from female to male is a personal decision that requires proper preparation and the opportunity to calmly discuss all important issues with a specialist. It is important for a person to feel confident, understand the possible stages of transition, and be able to receive professional medical support at each of them.

At the “Oxford Medical” clinic, consultations are conducted by plastic and genital surgeons with more than 20 years of experience who specialize in such surgical interventions. During the appointment, it is possible to learn about the possibilities of modern surgery, the specifics of preparation for the operation, and further recovery. If you are considering a transgender transition from female to male, we invite you to schedule a consultation with an “Oxford Medical” specialist.

FTM (Female-to-Male) is a transition from female to male, which may include hormone therapy, surgical interventions, and further medical support. For each person, this process takes place individually — depending on the state of health and the scope of desired changes.

During FTM transition, hormone therapy helps gradually form more masculine features of appearance. The tone of voice, hair growth on the body and face, distribution of fatty tissue, body contours, and other secondary sex characteristics may change.

The surgical stage may also include different types of interventions. For some patients, the main stage is an operation on the chest — mastectomy or reconstructive mammoplasty to form a more masculine contour of the chest. The transition plan may also include reconstructive interventions on the genitals or correction of individual features of appearance.

The doctors of “Oxford Medical” note: it is important to understand that FTM transition does not have a single standard scenario. For some, hormone therapy and one surgical stage are enough, while others go through a more complex process. That is why the transition plan is formed individually after consultations and necessary examinations.

The surgical stage of FTM transition may consist of one or several interventions. The plan of operations is formed individually — depending on exactly what changes a person wants to receive.

During transition, the following operations may be performed:

• mastectomy — an operation on the chest to form a more masculine contour of the chest;
• hysterectomy — removal of the uterus;
• ovariectomy — removal of the ovaries;
• metoidioplasty — formation of a neophallus from tissues that change under the influence of testosterone;
• phalloplasty — creation of a penis using the patient’s own tissues;
• urethroplasty — reconstruction of the urethra to change the method of urination;
• reconstructive interventions on the scrotum — formation of the scrotum and, if necessary, placement of implants.

Not all stages of transition are performed simultaneously. In many cases, breaks of several months are needed between operations for tissue healing and recovery of the body. That is why sex change from female to male usually takes place gradually.

The doctors of “Oxford Medical” recommend discussing in detail with a specialist, even before the beginning of the surgical stage, the possible results of operations, the features of recovery, and further medical support.

For many people who have decided to change sex from female to male, FTM surgery becomes an important part of transition and helps them feel more comfortable in their own body. Most often, the surgical stage is considered when female sex characteristics cause pronounced internal discomfort and a person seeks to bring appearance into accordance with their gender identity.

Before the operation, it is important to take tests and undergo examinations, as well as discuss with specialists the features of health, hormone therapy, and possible stages of transition. This helps prepare the body better for the intervention and reduce the risk of complications during recovery.

Surgical intervention may be temporarily postponed or not recommended in the following conditions:

• severe blood clotting disorders;
• decompensated cardiovascular diseases;
• acute infectious or inflammatory processes;
• uncontrolled hormonal disorders;
• severe conditions in which anesthesia is dangerous;
• exacerbation of chronic diseases.

In some cases, additional treatment or correction of therapy may be needed before the operation. After stabilization of the condition, a person can usually return to planning the surgical stage.

The doctors of “Oxford Medical” recommend openly asking all questions that concern you before the operation and not rushing decisions. Calm preparation and a detailed discussion of all stages help you feel more confident before transition.

One of the important stages of preparation is hormone therapy. It helps gradually form more masculine features of appearance, affects the distribution of fatty tissue, voice timbre, hair growth, and other secondary sex characteristics. Gradually, the appearance becomes less feminine, which for many patients is an important part of transition. Hormone therapy is also important for preparing tissues for further surgical interventions.

Also, before the operation, it is important to undergo a comprehensive examination and assess the general state of health. The following may be recommended:

• consultation with a surgeon;
• consultation with an anesthesiologist;
• consultation with an endocrinologist;
• consultation with a psychiatrist or psychotherapist;
• laboratory blood and urine tests;
• coagulogram;
• electrocardiogram (ECG);
• fluorography or X-ray of the chest organs;
• transvaginal ultrasound;
• additional examinations according to indications.

A few weeks before the operation, the doctor may recommend temporarily limiting smoking, alcohol, or adjusting the intake of certain medications. You cannot independently stop hormone therapy or change the treatment regimen — all changes must be agreed with a specialist.

Sex reassignment surgery from female to male may include different interventions: from correction of the chest to reconstructive operations on the genitals. They are not always performed simultaneously — the sequence depends on the scope of changes, the state of health, and the body’s readiness for the next stage.

On the day of the operation, the patient undergoes hospitalization and a final examination by the doctor. Before the intervention, a consultation with an anesthesiologist is also conducted, during which the results of examinations, medication intake, features of hormone therapy, and possible reactions to anesthesia are clarified.

The main stages of surgical treatment may include:

• preoperative preparation;
• performing the operation under general anesthesia;
• staying in the inpatient department under medical supervision;
• dressings and control of healing;
• further rehabilitation and follow-up examinations.

The duration of the operation depends on the type of intervention. For example, operations on the chest usually last several hours, while complex reconstructive stages may require more time and longer postoperative observation.

At the “Oxford Medical” medical center, surgical interventions are performed in a modern high-tech inpatient department equipped with expert-class equipment. After the operation, the patient stays under round-the-clock medical supervision — doctors monitor well-being, the healing process, and the condition of the postoperative area.

For comfortable recovery in the inpatient department, single and double hotel-type rooms with functional beds, separate bathrooms, air conditioning, Wi-Fi, and call buttons for medical staff are provided. Patients are provided with postoperative care, full nutrition, and constant support from medical staff.

The duration of recovery after FTM surgery depends on the type of surgical intervention and the individual characteristics of the body. After operations on the chest, rehabilitation usually proceeds faster than after complex reconstructive interventions on the genitals.

During the recovery period, it is usually recommended to:

• limit intense physical activity;
• temporarily avoid lifting heavy objects;
• avoid overheating of the body;
• not visit the sauna, swimming pool, and hot baths;
• regularly undergo follow-up examinations;
• not independently change the regimen of taking medications or hormone therapy.

In the first weeks after the operation, swelling, discomfort, increased tissue sensitivity, or a temporary feeling of tightness may persist. Such manifestations gradually decrease as the tissues heal.

After operations on the chest, the patient may be recommended to wear compression garments for the correct formation of contours and reduction of postoperative swelling. If reconstructive interventions on the genitals were performed, recovery may be longer and require more careful care of the postoperative area.

After FTM transition, hormone therapy usually continues under the supervision of a specialist. During this period, it is important to regularly undergo examinations and monitor the state of health.

For some patients, psychological adaptation to changes in appearance and a new stage of life is also an important stage of recovery. If necessary, a person may seek support from a psychotherapist or another specialist in the field of mental health.

The doctors of “Oxford Medical” recommend not ignoring any unusual symptoms after the operation. If severe pain, pronounced swelling, bleeding, fever, or worsening of well-being appears, it is important to consult a doctor as soon as possible.

After FTM transition, some changes in the body become irreversible. Therefore, even before the beginning of the surgical stage, it is important to discuss with a specialist the features of the further lifestyle, hormone therapy, and medical monitoring.

After transition, a person usually needs to regularly undergo follow-up examinations and monitor the state of health. Long-term hormone therapy requires periodic monitoring of tests and observation by an endocrinologist.

The issue of fertility requires separate attention. Hormone therapy and some surgical interventions may affect the possibility of having biological children in the future. That is why this issue should preferably be discussed even before the beginning of the operative stage of transition.

After reconstructive operations on the genitals, the features of intimate hygiene, tissue sensitivity, and sexual life may change. For full adaptation of the body after such interventions, time is usually needed.

The doctors of “Oxford Medical” recommend not being left alone with worries or questions. Open communication with a specialist helps to go through the stage of transition more calmly and better prepare for further changes in life.

The cost of FTM transition depends on the scope of surgical interventions, the number of stages, the duration of stay in the inpatient department, and the features of postoperative recovery. If the transition includes several operations, the final price is formed individually.

You can preliminarily familiarize yourself with the prices for medical services here. To schedule a consultation, leave a request through the online appointment form on the website or contact the clinic’s contact center at a time convenient for you.