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Lower (more commonly referred to as "bottom") surgery for male-to-female (MtF) transition can refer to vaginoplasty, orchiectomy, penectomy, and/or labiaplasty. (Yes, there needs to be more explanation of these...) Vaginoplasty, with or without labiaplasty, is often referred to as SRS (sex reassignment surgery), GRS (genital reconstruction surgery / gender reassignment surgery), or GCS (gender confirmation surgery) -- although some of these terms may also be used to refer to other types of gender-transition surgery as well.

General Information







Much is made about post-surgical regret, but as far as I can tell this happens only for one of the following reasons:

  • The patient is coerced into surgery as a condition for receiving other services or supplies necessary for transitioning (e.g. hormones)
  • The patient has mistaken ideas about the benefits or risks of surgery, and is allowed to proceed without first being fully informed (this is why the "informed" part of informed consent is crucial)
  • The surgery goes badly (seems to be very rare),
  • The surgery results in reduced genital sensation, which sometimes leads to regret.


  • A WARNING FOR THOSE CONSIDERING MtF SRS by Lynn Conway: transitioning for the wrong reasons: discusses Renée Richards, Dani Bunten Berry, Sandra MacDougall, Samantha Kane
  • 2010-06-06 Sex Reassignment Surgery: When Things Go Wrong -- article by a transwoman whose surgery, though genuinely wanted and for the right reasons, had gone poorly (her lower intestine was nicked by a surgical retractor) and she was stuck wearing a colostomy bag, and without a properly-shaped neovagina. I haven't been able to find any information about whether she was ultimately able to get this fixed. --Woozle (talk) 15:37, 5 September 2016 (EDT)

anti-trans propagandists

This stuff should be mostly moved to Issuepedia


  • Walt Heyer and Jerry Leach, both of whom have apparently made careers out of their surgery regrets, allegedly both lied to their therapists in order to get surgery recommendations. (Still trying to track down this claim.)

Questions to Ask

(Where possible, get answers from web site first; perhaps confirm with surgeon.)

  • Do you have a fixed price for the procedure? If not, can you estimate the likely cost?
  • How long is your wait-list, at present, for a surgery appointment?
  • How soon could I get an appointment for an initial consultation?
  • When did you first start doing vaginoplasty?
  • Approximately how many vaginoplasties have you performed?
  • Have any of your vaginoplasty patients reported unexpected issues?
  • Do you prefer to do vaginoplasty in a single operation, or labia and clitoral hood separately?
  • Can you put me in touch with transwomen whose surgeries you performed (or point me at what they've written about their experiences)?