Some trans and gender diverse people benefit from gender-affirming surgery to create physical characteristics reflective of one’s gender identity or gender expression.
Surgical care may include gonadectomy and/or genital reconstruction surgery. After you have decided to proceed with surgery, work with your primary care provider to understand the types of surgery and the benefits, complications and risks associated with each. Make sure you take time to understand which surgery is right for you.
The following gender-affirming, lower body surgeries (and any surgical revisions required) are funded by BC Medical Services Plan (MSP):
- Orchiectomy surgery removes the gonads (testes) and spermatic cord. It can be done with or without scrotectomy (removal of scrotal sac).
- Hysterectomy with bilateral salpingo-oophorectomy removes the uterus, the fallopian tubes and the ovaries. At times, one or both ovaries are left in place.
- Vulvoplasty surgery creates the vulva (including mons, labia, clitoris, and urethral opening) and removal of penis, scrotum, and testes.
- Vaginoplasty surgery creates a vaginal canal and vulva (including a mons, labia, clitoris and urethral opening) and removes and inverts the erectile tissue (penis), gonads (testes) and external genital (scrotal sac).
- Erectile tissue release surgery creates a penis by cutting ligaments around the erectile tissue (clitoris) that has been enlarged by testosterone to release it from the pubis and give the shaft more length (4 to 6 cm). A scrotum can be created from the labia. Testicular implants can be inserted in the scrotum in a separate surgery, months later.
- Metoidioplasty surgery creates a penis by cutting ligaments around the erectile tissue (clitoris) to release it from the pubis and give the shaft more length (4 to 6 cm). Skin from the external genitals (labia or outer labia) is wrapped around the penis to add girth. A scrotum can be created from the labia. Testicular implants can be inserted in the scrotum in a separate surgery, months later.
- Phalloplasty surgery takes place over multiple surgeries. These procedures create a penis from tissue typically grafted from the forearm or thigh. A scrotum can be created from the labia. Testicular implants and a penile prosthesis can be inserted in a separate surgery, months later.
These procedures are also known as feminizing surgeries and masculinizing surgeries. To be more inclusive of diverse gender identities, we are using language that focuses on anatomy, treatments and presenting concerns, rather than gender.