Female to Male (FTM) Sex Reassignment Surgery is the last solution to treat ”Gender Identity Disorder” to create an analogous male genitalia to conform to the patients deepest feeling of self-being in gender identity. Female to Male “SRS” is a surgical procedure with a history of decades, and is in progressive development through continuous medical studies, medical research and advanced technology in surgical technique. The present achievement is successful than before with high quality of standard care and treatment just like Male to Female “SRS”, only it is more complicated and lengthy, the procedure is about one to two years to complete.

Stages for FTM Reassignment Surgery
Stage One

1:1 Subcutaneous Mastectomy
This surgery is the reduction of breast volume to provide the patient with a masculine chest features. A semi-circular U shape incision located at the junction of the normal skin and areola skin is made. The incision leaves minimal scarring, easily hidden upon recovery, as the skin pigment will blend with the colour of the areola. The procedure is approximately 2 hours, after the surgery the surgeon will place a tube for two days to drain the blood and prevent accumulation. Stitches will be removed after 1-2 weeks.
COST : USD 2,200

1:2 Total Removals of Uterus and Ovaries
Male do not have uterus and ovaries therefore it is very important that uterus and ovaries are removed for this group of patient so that they do not face the problem with menstruation and in the other hand eliminate the hormone producing organ. This is done by a gynaecologist and can be done together with Subcutaneous Mastectomy. After the first and second procedure, when the wound in the breast and the internal and external abdominal wound is totally healed at approximately three months, there will be a follow up check with the surgeon to evaluate the condition of the wound and tissue to prepare for the second stage procedure.
COST : USD 1,500

Stage Two

2.1: Vaginal Closure and urethral lengthening
This is the step wherein the path of the urinary tract is altered and the vaginal closure. It is because the direction of the female urinary tract is facing downward while the male urinary tract is in front. Therefore the surgeon is required to alter the direction of the urinary tract and completely close the vagina. The length of the urethra is also created longer and prepared to join with the urethra at the forearm in the last step. Surgeon will lop off the wall of the vagina and fold it back outward (vaginal mucosa reflection) and lop off the tissues in the vagina and stitched to closed it completely.
COST : USD 2,700

When this procedure is completed the patient will not have a vaginal opening and the patient can urinate at the front direction, like that of a male but without the penis yet.
The healing process takes about 2-3 weeks; the patient is required to stay in the hospital for 2 days. A catheter will be inserted for about 7-10 days; it will be removed after the urinary tract is healed.

2.2: Urethral prefabrication
Is the preparation of urethra to the penis (using the forearm flap Phalloplasty). In creating the penis at Yanhee Hospital, the surgeon uses the forearm fascia, skin; nerves and blood vessels are raised and transplanted by microsurgical technique. To reduce the percentage of urine leakage the surgeon will create a urethra by wrapping the catheter with gluteal skin and bury into the forearm. After the grafted skin is healed, the result is a sturdy urethral tube, and when used to create the penis, percentage of urine leakage is minimal. The surgery is only one hour and the patient is required to stay in the hospital for 2 days. After the surgery, the patient will have a catheter in the forearm and will be on a regular check up by the surgeon along with self-care procedures for 3 months until the urethra constructed in the forearm is ready for the next step.
COST : USD 1,500

Stage Three

Phalloplasty
Is the construction of the male genital organ. As the patient reached this stage, external physical features of the patient is almost that of a male, flat chest, no ovaries, no uterus, able to void at standing position but without the male organ to control the direction and flow of urine. Hence, the surgeon will create the male organ by transferring the forearm flap and join the structures through microsurgical technique. 4-6 inches penis, depending on the length of the patients’ forearm can be obtained. On the average, length is about five inches. The surgeon separates the blood vessels and nerves of the forearm to connect with the blood vessels and nerves in the pubic area then create a scrotal sac from the tissues of the labia, this scrotal sac consist fat and pigmented skin of the labia, but without testicles inside. External appearance is similar to the male scrotal sac.
All patients that complete these stages have the successfully reconstructed penis and all the physical changes from female to male without any residual female sex organs. No serious complications such as flap failure, infection, serious wound complications and urination leakage found. Patients all recover from the surgery fast because each stage consumes short time period without the need to correct the serious complication. All of them can urinate through the end of the neo-penis and the external appearance is similar to that of the genetic male sexual organ and also sensated.
COST : USD 6,900