The male to female sex change (MTF) procedure does not involve surgery for everyone. Studies indicate that only about 25 to 30 percent of gender reassignment patients go through surgery in addition to hormone treatments. For trans women wanting the male to female (MTF) transition, this surgery generally is more effective, less costly and simpler than female to male (FTM) surgery.
The surgeon removes the testicles and the majority of the penis, leaving behind skin, nerves and a blood supply. He then cuts the urethra, as it doesn’t have to run as far in a female anatomy. The remaining skin is used to build a vagina that is generally functional. Some procedures allow for some of the skin of the penis to work as a “neoclitoris.” After the recovery time has passed, sexual intercourse is comparable in terms of experience and satisfaction to that of a biological woman.
Some male to female (MTF) sex change patients also have breast implants, while others just rely on the hormone treatment for growing breasts. Most trans women find that they grow breasts that are about a cup size or two smaller than the breasts their mothers and/or sisters have.
Male to female (MTF) sex change surgery is the last stage in the transformation. Patients do not qualify for surgery until they have received a diagnosis of gender dysphoria or gender identity disorder from a psychotherapist and then gone through a course of hormone treatment. After living for at least a year as a woman, they are eligible to undergo surgical procedures in most cases. The reason for this length of time is to ensure that the male to female (MTF) sex change brings about the positive change that the patient needed in his life at the beginning of the treatment cycle.
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