Masculinizing Surgeries

Masculinizing surgeries are gender-affirming surgical procedures that create physical characteristics reflective of one’s gender identity and/or gender expression.

What masculinizing surgeries are covered by the BC Medical Services Plan (MSP)?

Listed below are some links that will provide details about some of the masculinizing surgeries that are currently available.

Chest surgery

Chest surgery is a gender-affirming, masculinizing top surgery that removes breast*breast* (with an asterisk) is used to acknowledge the many different words that are used for this body part. tissue and sculpts remaining tissue into a shape that is typically considered to be more masculine.

Hysterectomy with bilateral salpingo-oophorectomy

Hysterectomy with bilateral salpingo-oophorectomy are two gender-affirming, masculinizing lower surgeries. Hysterectomy is a surgical procedure to remove all or part of the uterus*uterus* (with an asterisk) is used to acknowledge the many different words that are used for this body part., and sometimes the ovaries*ovaries* (with an asterisk) is used to acknowledge the many different words that are used for this body part. and/or fallopian tubes*fallopian tubes* (with an asterisk) is used to acknowledge the many different words that are used for this body part.; a gender-affirming, masculinizing lower surgery. Oophorectomy is a surgery to remove the ovaries*; a gender-affirming, masculinizing lower surgery.

Clitoral release

Clitoral release is a gender-affirming, masculinizing, lower surgery to cut ligaments around the clitoris*clitoris* (with an asterisk) is used to acknowledge the many different words that are used for this body part., releasing it from the pubis*pubis* (with an asterisk) is used to acknowledge the many different words that are used for this body part., giving the shaft more length, thus creating a penis.

Metiodioplasty

Metoidioplasty is a gender-affirming, masculinizing, lower surgery to create a penis and scrotum, done by cutting ligaments around the clitoris* to add length to the shaft, grafting skin around the shaft to create added girth, lengthening the urethra so one can urinate from the shaft, and creating a scrotum.

Phalloplasty

Phalloplasty is a gender-affirming, masculinizing, lower surgery to create a penis and scrotal sac (phase 1), then testicular implants and implants to obtain rigidity/erection (phases 2 and 3).

Surgery What is it? Goals

Chest surgery by a plastic surgeon in BC.

Unwanted skin and tissue is removed from the chest. The chest is sculpted into a ‘typical male shape.’

A chest with sensation

Nipples with sensation (varies by technique)

A fairly symmetrical chest with aesthetically pleasing contouring

Minimal scarring (varies by technique)

Hysterectomy with bilateral salpingo oophorectomy by any obstetrician/ gynecologist in BC.

The ovaries*, fallopian tubes*, and uterus* are removed.

To prevent monthly bleeding

To eliminate the need for regular pap tests

To allow you to lower your dose of testosterone, reducing its unwanted side effects and risks

To eliminate the risk of ovarian, uterine, and cervical cancer

Clitoral Release by GRS Clinic Montreal.

The clitoris*, enlarged by testosterone, is freed from the surrounding tissue to create a penis of about 4-6cm. A scrotum can be created from the labia. Testicular implants can be inserted in the scrotum in a separate surgery, months later.

To create a phallus that has sexual sensation and can get erections without the assistance of an implant

To leave the vagina* intact

Does not enable urination while standing

The goal is not to enable penetration

Metoidioplasty by GRS in Montreal.

The clitoris*, enlarged by testosterone, is freed from the surrounding tissue to create a penis of about 4-6cm long. The urethra is lengthened and incorporated into the penis. Skin from the labia*labia* (with an asterisk) is used to acknowledge the many different words that are used for this body part. is wrapped around the penis to add girth. A scrotum can be created from the labia*. Testicular implants can be inserted in the scrotum in a separate surgery months later.

To create a penis that has sexual sensation and can get erections without the assistance of an implant

To enable the ability to pee while standing

The goal is not to enable sexual penetration

Free-Forearm Flap Phalloplasty by GRS in Montreal.

An average-sized penis (around 14cm) is created using tissues from your genitals and forearm. A scrotum can be created from the labia*. Testicular implants can be inserted in the scrotum in a separate surgery months later. An implant to get erections can also be inserted at this time.

To create a penis of typical size and shape with preserved sexual sensation

To create a penis with enough length and bulk to be used for penetrative sexual intercourse

To enable the ability to pee while standing

To create a penis that can get erections with the assistance of an implant (if desired).

What masculinizing surgeries are available that are not covered by the BC Medical Services Plan?

  • Liposuction
  • Lipofilling
  • Pectoral implants
  • Voice surgery

I have a consultation for a masculinizing surgery. What should I talk to my surgeon about?

During your surgical consultation, ask your surgeon about:

  • The different surgical techniques available
  • The advantages and disadvantages of each technique
  • The limitations of a procedure to achieve “ideal” results
  • Before-and-after photographs of their own patients, including both successful and unsuccessful outcomes
  • The risks and possible complications of the various techniques
  • The surgeon’s own complication rates for each procedure

What should I consider when deciding on an external genital surgery?

There are three MSP-funded masculinizing genital surgeries: clitoral release, metoidioplaty and phalloplasty. The one that suits you best depends on many factors:

  • Are you okay with having visible scars?
  • Do you want to urinate standing up or sitting down?
  • Do you want to have penetrative sex with your penis?
  • Is the site of sexual sensation important to you?
  • Do you want to still use your vagina*vagina* (with an asterisk) is used to acknowledge the many different words that are used for this body part.?
  • How many operations are you prepared to have?
  • What level of risk are you willing to accept?
  • Do you have any health-related restrictions on your options?
  • What can you afford to do (in terms of aftercare costs, time off work, etc.)?

Should I get electrolysis before surgery?

Check with your surgeon and follow their advice. At GRS Montreal, you are advised to get electrolysis (hair removal) on your forearm at least 12 months before surgery.

Should I stop taking hormones before masculinizing genital surgery?

This is debatable. GRS Montreal does not advise you to stop taking hormone therapy before clitoral release, metoidioplasty or phalloplasty. Follow your surgeon’s advice.

What if I need an external genital surgery revision?

You and your surgeon can determine whether a surgical revision is necessary 6-8 months after your surgery is complete. With a letter of recommendation from your surgeon, the cost of your revision will be covered by the BC Medical Services Plan.

Typical genital surgery revisions include, but aren’t limited to:

  • Corrections to the urethra
  • Revisions of the coronal rim (the part the connects the head of the penis with the shaft)
  • Implant replacement

If you choose to have testicular implants and/or erectile prostheses placed later, it is simple to perform minor “touch-ups” at the same time.