Male to Female (MTF)

An Overview of Male to Female Transformation (MTF)

When it comes to male to female transformation (MTF), the surgical aspects involve changing the male genitalia so that they resemble and work as similarly to female genitalia as possible. Before the surgery takes place, patients go through hormone replacement therapy, or HRT, and when appropriate, the removal of facial hair. By the end of the process, people who identify as women but have spent their entire lives feeling trapped in a male body emerge emancipated, ready to live a full life that allows them to express themselves physically, sexually and emotionally in accord with their true identity.

One of the first people to go through the male to female transformation was Lili Elbe, who went through five different surgeries in Germany in the early 1930s. The first famous male to female transformation patient was Christine Jorgensen, who went through the process in 1952 and spent the rest of her life advocating for transgender rights. The first male to female transformation in the United States happened in 1966 at Baltimore’s Johns Hopkins University, performed by Dr. Elmer Belt. Since then, the process has become more and more common, and in recent years, attitudes about male to female transformation have become increasingly tolerant.

The genital surgery associated with male to female transformation (MTF) involves the removal of the testicles and the inversion of the penis and the foreskin. The nerve and blood supply to the area is retained in a flap, so that the patient still has full physical sensation. The glans of the penis becomes a clitoris that has enough nerve endings to provide sexual pleasure. If the patient has been circumcised or in other cases where more skin is needed to form the vaginal lining, surgeons bring grafts from the hips or thighs. No matter which way the procedure happens, the sexual pleasure is comparable to that of a biological woman.

In addition to genital surgery, this transformation also involves a number of procedures to complete the aesthetic change from a man to a woman. Surgeries that modify cartilage or bone structures, most often in the cheek, nose, forehead, eyebrow and jaw areas, are called facial feminization surgeries (FFS). The purpose of these is to have the patient’s face look as feminine as possible. If hormone replacement therapy does not provide enough breast growth, a patient may choose to have breast augmentation. In most cases, trans women (people going through the MTF transformation) end up with a cup or two smaller breast size than their sisters or mother, and some trans women choose augmentation to make their transformation more aesthetically satisfactory.

Another aesthetic procedure that some choose in this process is the tracheal shave. This lessens the amount of cartilage around the throat to cut down on the Adam’s apple and make the throat look more feminine. Some male to female transformation patients choose voice surgery to change the pitch or range of the vocal cords. Estrogen treatment alone cannot change a person’s voice, which is why some choose to go through this surgical procedure. For those who do not opt for surgery, there are also voice feminization instructors who help teach trans women to add feminine tones to their speech.

Another aesthetic procedure that some patients choose as part of the male to female transformation (MTF) is buttock augmentation. Biological men have smaller buttocks and hips, for the most part, than their biological female counterparts. For patients who identify as a woman before puberty has ended and start their hormone therapy at that time, the pelvis broadens to a small degree. For patients who are out of their teenage years, the hormone treatment does distribute a subcutaneous fat layer over the contours that round the body. Those who start the hormones while still teens can end up with a waist to hip ratio of 0.7 or even lower, although the typical ratio is about 0.8. Some want to achieve a smaller ratio than what hormones can provide and so go through an augmentation procedure.

Every person who chooses to go through male to female transformation (MTF) has a unique path to take, emotionally, sexually and aesthetically. The providers who are available through are sensitive to the needs of all people considering this step to embrace their true identity.

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