Frequently asked questions

Female to Male FAQ | Metoidioplasty

1. This word can be spelled different ways, what is the correct wording?

In English, we use the word metoidioplasty. In French, we call it métaiodoplastie. The word meta can be used as well.
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2. Can I procreate (father a child) after having metoidioplasty?

No, the surgery will not allow you to father a child. The main objective of this surgery is to obtain the most natural as possible male external genitals. To have children, your body needs internal male structures like testes, where sperm is created, and a prostate, which makes secretions of male seminal fluid possible.
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3. Should I stop taking my testosterone before or after surgery?

No, you can continue taking your testosterone according to your regular schedule.
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4. Which methods are used to have biological children?

Depending on your goals and expectations, your doctor will be able to provide you with information and resources. Discuss your options with your doctor before surgery.
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5. What is the average penis length following metoidioplasty?

Taking testosterone causes the clitoris to lengthen, which will then stabilize. The final appearance of the genitalia is influenced by the current enlargement of the clitoris and by your personal body situation, for example the amount of fat accumulated around the pubis and the elasticity of the skin of the genitals. Being overweight with an excessive accumulation of fat around the pubis and having loose genital skin may give the impression that the penis is smaller.

GrS Montréal surgeons work with each client individually to obtain optimal surgical results.

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6. Will my clitoris be longer after metoidioplasty?

No, but the complete release of the clitoral ligaments places the clitoris in a more advanced position and gives the impression that it is longer.

However, it is possible, if you wish, to practice pumping to try to give your phallus more length and girth. Please refer to the information booklet A for more information.
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7. Can I have a metoidioplasty without closing the vaginal cavity?

Yes, this is possible. Please consult the metoidioplasty section to learn more about the different surgical technics.
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8. Is hysterectomy mandatory?

No, hysterectomy is not mandatory if you do not wish to undergo vaginectomy during your metoidioplasty.
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9. Is it possible to keep one or two of my ovaries during hysterectomy?

It is possible to keep your ovaries and/or your fallopian tubes during hysterectomy. We recommend you to discuss this decision with your health care providers. To undergo vaginectomy during metoidioplasty, it is mandatory to have your uterus and cervix removed at least 6 months before metoidioplasty.
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10. Can I choose the size of my testicular implants?

The size of your testicular implants will be selected with the surgeon who will advise you in order to obtain the most aesthetic results possible based on your appearance.
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11. What is the lifespan of testicular implants?

The implants can be left in place for as long as no complications arise. If you do have a problem with one or both implants, it is important to contact your surgeon.
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12. Which medications will be prescribed to me after surgery?

We will mainly prescribe medications like antibiotics, anti-inflammatories, and medication to relieve your pain. Your medication will be adjusted and modified according to your medical situation.
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13. Do I need to remove the sutures after surgery?

There is no need to concern yourself with removing your sutures once you return home. Your incisions will be closed using “dissolvable stiches” that dissolve completely in about 30 to 90 days.
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14. How long do I need to keep the urinary catheter in place after surgery?

The urinary catheter is the tube through which your urine will flow during the days following your procedure. If you chose a metoidioplasty with neo0urethra, It will be left in place with a thigh drainage bagfor a period determined by your surgeon.
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15. Will I be able to urinate standing up after the procedure?

Among the available techniques, metoidioplasty with lengthening of the urethra will allow you to urinate standing up. However, please note that it will not be possible to urinate through the zipper of your pants, limiting the access to public urinals.

*Following surgery, it is possible that you will experience difficulty urinating standing up due to inflammation present in the genital area. Inflammation can take up to 1 year to disappear completely. You should therefore see an improvement in your ability to urinate standing up within the first year following surgery.
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16. Will I be able to have an orgasm after metoidioplasty?

Yes, the erogenous and erectile nature of the clitoris is maintained, allowing for sexual pleasure.
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17. Will it be possible to ejaculate during orgasm after my surgery?

No, ejaculatory fluid expelled by the penis during sexual stimulation will not be possible since internal male structures, such as the prostate, seminal vesicles, and glands are absent. However, a clear fluid may flow from the urethra. This fluid comes from the Skene’s glands, which are normally preserved during surgery, and may be expelled in a variable amount from one person to another.
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18. Will I be able to perform sex with penetration after surgery?

No, unfortunately the penis is not long enough to perform sex with penetration
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19. I have had metoidioplasty without lengthening of the urethra and I am satisfied with my results, but I would like to be able to urinate standing up. Can I come back for another procedure to lengthen my urethra?

Unfortunately, it is not possible to lengthen the urethra at a later time since the tissues required for the elongation of the urethra will have been modified or removed during the first procedure.
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20. I have had metoidioplasty and I am not satisfied with my results or my needs have changed. What are my options?

Please communicate with Asclepiade or the postop nurse in charge of your follow-up so a member of our team can assess. If a revision is required, you will discuss different options with your surgeon. GrS Montréal surgeons are ready to listen to your needs and offer solutions. If your needs and expectations have changed, please note that it is possible to have phalloplasty surgery even if you have already had metoidioplasty. It is important to communicate with your surgeon if you are not satisfied with the results of your surgery.

*It is important to take the time to fully understand the surgeries available and to contact us if you have any questions. Information available online does not necessarily correspond to your situation. Accuracy of information and a clear understanding will help you make an informed choice on surgery and, in certain cases, may prevent you from having to resort to undergoing an additional surgical procedure.
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