Masculinizing Surgeries

Masculinizing surgeries are gender-affirming surgical procedures that create physical characteristics reflective of one’s gender identity or gender expression.

Chest surgery 

Chest surgery is a gender-affirming, masculinizing top surgery that removes unwanted breast tissue and sculpts the remaining tissue into a flatter shape. The goal is to have a chest with sensation, nipples with sensation (varies by technique), a fairly symmetrical chest with aesthetically pleasing contouring and minimal scarring (varies by technique). This surgery is done by a plastic surgeon in BC. Visit the chest surgery page for more information.

Clitoral release

Clitoral release is a gender-affirming, masculinizing, lower surgery that creates a penis by cutting ligaments around the clitoris (which 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. The goal is to create a phallus with sexual sensation that can get erections without the assistance of an implant and to leave the vagina intact. This surgery does not enable urination while standing and the goal is not to enable sexual penetration. This surgery is done at GRS Montreal (Gender Reassignment Surgery). Visit the clitoral release page for more information.

Hysterectomy with bilateral salpingo-oophorectomy

Hysterectomy with bilateral salpingo-oophorectomy are two gender-affirming, masculinizing lower surgeries. Hysterectomy removes all or part of the uterus* and sometimes the ovaries or fallopian tubes. Oophorectomy removes one or both of the ovaries. The goal is to prevent monthly bleeding, eliminate the need for regular Pap tests, allow you to lower your dose of testosterone, reducing its unwanted side effects and risks, and eliminate the risk of ovarian, uterine and cervical cancer. This surgery is done by an obstetrician or gynecologist in BC. Visit the hysterectomy with bilateral salpingo-oophorectomy page for more information.

Metiodioplasty

Metoidioplasty is a gender-affirming, masculinizing, lower surgery that creates a penis by cutting ligaments around the clitoris* (which has been enlarged by testosterone) to release it from the pubis* and give the shaft more length (4 to 6 cm). The urethra can be lengthened and incorporated into the penis. Skin from the 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. The goal is to create a penis with sexual sensation that can get erections without the assistance of an implant and to enable the ability to pee while standing. The goal is not to enable sexual penetration. This surgery is done at GRS Montreal (Gender Reassignment Surgery). Visit the metodioplasty page for more information.

Phalloplasty

Phalloplasty is a gender-affirming, masculinizing, lower surgery that creates a penis and scrotal sac (phase 1), then testicular implants in the scrotum and implants for erection (phases 2 and 3). The penis is created using tissues from your genitals and forearm. The scrotum can be created from the labia*. Testicular implants can be inserted in the scrotum in a separate surgery months later. An implant to get erections can also be inserted at this time. The goal is to create a penis that preserves sexual sensation that can get erections with the assistance of an implant (if desired) and with enough length and bulk to be used for penetrative sexual intercourse, and to enable the ability to pee while standing. This surgery is done at GRS Montreal (Gender Reassignment Surgery). Visit the phalloplasty page for more information.

Surgical revision

A surgical revision, if needed, typically takes place 6 to 8 months after your surgery is complete. With a letter of recommendation from your surgeon, the cost of your revision will be covered by the BC MSP. Common reasons for a surgical revision include:

  • removal of puckering, after chest surgery
  • corrections to the urethra
  • revisions of the coronal rim (the part that connects the head of the penis with the shaft)
  • implant replacement

If you choose to have testicular implants or erectile prostheses placed later, minor “touch-ups” can be done at the same time.

Other gender-affirming, masculinzing surgeries

Other gender-affirming masculinzing surgeries that may be considered include liposuction or lipofilling, pectoral implants or voice surgery. However, these procedures are currently not covered by MSP BC.

MSP in BC covers chest surgery, hysterectomy with bilateral salpingo-oophorectomy, clitoral release, metoidioplasty and phalloplasty. 

SOURCE: Masculinizing Surgeries ( )
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