Surgical modification of the female primary and secondary sexual anatomy into masculine features is a series of procedures that can take about a year or more to complete.  Biological females diagnosed with Gender Identity Disorder may be eligible for this surgery upon submission of required supporting documents (see Special Requirements section).

There are three stages in the female to male sex change surgery separated by 3-6 months interval.

STAGE 1

Mastectomy: a surgical procedure that removes breast tissue to achieve a masculine chest contour.  The surgical technique will depend on the volume of breast tissue and skin to be excised.

Total Abdominal Hysterectomy with Salpingo-Oophorectomy (TAHBSO): a surgical procedure that removes the internal reproductive organs namely, uterus, fallopian tubes and ovaries.

STAGE 2 

Vaginectomy and Urethral Lengthening: surgery that obliterates the vaginal cavity and lengthens the urethra in preparation for incorporation into the new penis in the third stage.  This gives the patient ability to urinate effectively in the standing position.

Urethral prefabrication: preparation of a new penile graft in the forearm with embedded catheter which will serve as a functional intra-penile urethra after the third stage

STAGE 3

Total Phalloplasty: The forearm penile graft prepared during the second stage surgery is transferred to the genital area.  Nerves and blood vessels are conserved so the penis has sensation.  The new penis is expected to function as a male excretory organ for urine.  With the aid of an erectile prosthetic device, it can also achieve penetration during sexual intercourse.

During this procedure, the labia majora are converted into scrotal sacs.  The patient may opt to have prosthetic testes inserted in the scrotal sacs in a future surgery.

SPECIAL REQUIREMENTS

You need to be of legal age, in good health, and must submit the following requirements before your pre-surgical assessment for SRS-FTM

1. Letter of recommendation from two psychiatrists (one from a psychiatrist in patient’s own locality and one from a Thai psychiatrist) stating the following:

a. Diagnosis of female with Gender Identity Disorder

b. Declaration of successful real life experience as a male for at least 1 year

Certified psychiatrists issue this letter to individuals who meet the criteria of the Harry Benjamin International Gender Dysphoria Association

2. Medical certificate with details of male hormone therapy

a. Hormone intake must be prescribed and monitored by a licensed physician

b. Hormones have been taken for 1 year