Phalloplasty is a complicated procedure taking many years to complete. Deciding to go ahead with the surgery was a difficult decision. However, it’s a decision that I am now very happy to have made. In this blog, I map out my phalloplasty timeline. Linking to key videos from my journey, this blog starts from my initial decision to have surgery, through to referral, the operative stages, and completion.
What is Phalloplasty Surgery?
Phalloplasty is one form of genital reconstruction, (sometimes called lower surgery or bottom surgery) to create a penis for transgender and nonbinary people.
Lowe surgery explained in simple terms
How long Does it Take to Complete Phalloplasty Surgery?
It is difficult to say how long phalloplasty surgery takes to complete. The time largely depends on how well you heal after each stage, and whether you have any complications. It also depends on which country you have your surgery, as stages can differ depending on who performs your surgery. Waiting lists also affect completion time, especially in the UK where waiting lists are particularly long.
My Initial Hesitation for Lower Surgery
At the beginning of my transition, I didn’t think I would have lower surgery, especially not phalloplasty. The reasons for this are multiple and complex which I discuss in my phalloplasty memoir.
My main concerns were due to the lengthy and invasive nature of lower surgery, which is not without risks. Additionally, at the time I started my gender transition in 2010, there was little information available about lower surgery. There was also a murky undertow of myths and misconceptions about phalloplasty, which contributed to my hesitation and worry.
Realizing That I Needed to Have Lower Surgery
However, my views began to change soon after having my top surgery in November 2013. I began to become aware of an increase in gender dysphoria in relation to my lower half.
Struggling with lower surgery decisions
I decided to take some time to reflect on how I felt and to look again at lower surgery options. After lots of soul searching. I decided that I needed to pursue lower surgery. I decided that the best surgery for me would likely be radial forearm free-flap phalloplasty.
2014 June – Starting the Referal Process
At a follow-up appointment with my gender clinic, I informed my therapist of my change of heart. She agreed to put the surgery referral process in motion. At the time I transitioned, I needed two signatures in order to be referred for surgery. One signature could come from my clinic doctor, the other had to come from an independent psychiatrist.
2014 August – First Signature for Phalloplasty Referral
I received an appointment to see my clinic doctor quite quickly. I was nervous, not so much about the decision, but worried that I would be refused for some reason. This is a common worry for us trans folk!
Why I changed my mind about lower surgery
I need not have worried, my clinic doctor was happy to give me his first signature approval. I have been with the clinic a while by this point and he knew me well.
2014 September – Referral for Hair removal
My clinic therapist was keen to start the hair removal process ahead of time, as I am a hairy being! A referral was made and I began having laser hair removal sessions.
Consultation for laser hair removal
Reflecting at the end of my journey, I can honestly say I should have started hair removal earlier. However, the hair I have doesn’t bother me. I explain more in the vlog linked here.
Hair removal tips before having phalloplasty
2014 November – Second Signature for Phalloplasty Referral
My appointment with an independent psychiatrist came through quicker than I thought it might. My nerves were present again, especially as this was a psychiatrist I hadn’t met before. At the appointment, we talked through my transition so far, and my thoughts on lower surgery. We also talked about my medical history and lifestyle, to assess my suitability for surgery.
At the end of the appointment, he told me he was happy to sign off my second signature. Now I could be officially referred to the surgical team at St Peter’s Andrology Center in London.
Appointment for second signature
2015 January – Assessment at St Peter’s
In the New Year, I received an appointment for an assessment at St Peter’s Andrology. Once again the nerves spiked, what if this team decided I was not a suitable candidate for surgery!
The appointment was a chance to discuss my medical history and my options for surgery. We talked about my preference to have radial forearm phalloplasty. Then the consultant gave an overview of the risks involved and the possible complications.
Why I chose Radial Forearm Phalloplasty
Next, the consultant talked through the different stages, options within phalloplasty, and what would be happening at each stage.
Size options and considerations
Finally, the consultant had a look at my forearm, to assess the quality of skin and blood flow. I was a little concerned about my skin, as I have a history of self-harm. However, the consultant was happy my skin and blood flow were good. It would just mean that I would have some scars on my new penis, but I could live with that. I was then put on the official waiting list for the first stage of phalloplasty.
2015 August – First Stage Phalloplasty
My first stage of phalloplasty was at The Spire Thames Valley Hospital in Slough. At the first stage the following was completed:
- Creation of the phallus, using skin from the forearm to create the urethra and the penis
- Replacement skin was taken from the buttocks to replace the skin on the forearm
- Harvesting of nerves to give the tactile and erotic sensation
- One testicular implant
Playlist of stage one update and healing vlogs
This is the longest and undoubtedly the most difficult stage. I was in the hospital for ten days, and I am very happy I prepared well beforehand.
2016 April – Second Stage Phalloplasty
Waiting times began to get longer during my journey as more people were deciding to have lower surgery. At least this gave me time to heal properly between stages. Stage 2 took place at The Spire again and this time it involved:
- Completing the hook up of the urethra so I could stand to pee
- Glansplasty (creating the head of my penis)
- Vaginectomy (removal of the vagina)
- Hysterectomy
- Oopherectomy
Playlist of stage 2 updates and healing vlogs
Stage two went ahead with no issues, the urethral hook-up was successful, and soon, I was a forty-four-year-old man, learning to use the toilet all over again.
Standing to pee for the first time
2017 Jan – Third Stage Phalloplasty– Failed
My surgery seemed to be progressing well and I had been very lucky to not have any complications. The third stage, to fit the erectile device, would have been my final stage, but that was where my luck ran out! Unfortunately, due to an issue with my urethra, it wasn’t possible to fit the device.
I had developed what the surgeon called, a false passage, where my urethra had become baggy. If not fixed, this would likely cause issues further down the line. Therefore the procedure was abandoned, and my urethra repaired instead.
Stage 3 failure – urethral issues
2017 March – Urinary Issues Result in Being Unhooked
Unfortunately, once the catheter was removed after my stage 3 failure, I began to have problems. I suffered from severe pain and frequent urination.
Eventually, I was readmitted to the hospital, for investigation. It was discovered that the part of the urethra they had repaired, had developed a huge infection.
Urethral complications – stricture diagnosis
The surgeon decided that the best course of action was to unhook my urethra, to give it time to heal. Once everything had healed, I could then be rehooked back up. Returning to sit to pee was utterly devastating.
How I coped with urethral complications
2017 October – Rehook up Success
Once I had healed, I could be relisted for surgery. I was nervous returning to the hospital of St Johns, my fear was that the re hook up wouldnt work.
Thankfully, the procedure went well. After the catheter was removed, I returned to standing to pee. What an utter relief in every sense!
The simple joy of peeing
2018 August – Second Attempt at The Erectile Device
With everything healed and working well, it was time to attempt the final stage again. I dared not get too excited at the possibility of this being my final stage. I just took deep breaths and vowed to deal with whatever happened. To wake up and see an erection made me grin from ear to ear!
Stage 3 involved the insertion of the erectile implant. I chose the three-part inflatable device, the AMS 700. I also had the final part of my scrotoplasty. I found it hard to relax post-op. I was worried in case my body rejected the implant or if the wound degraded and the device broke through.
Playlist following the progress and healing of the final stage
Luckily none of those things happened. By a few months post-op, I allowed myself to breathe a sigh of relief. Now all I needed to do was learn how to use the erectile device!
For anyone interested, I have a video demonstration of the device, available on my Ko-fi Page Shop.
Review of the penile implant
My Phalloplasty is Complete!
It took a while for the fact to sink in, that I had completed my surgery and come to the end of my medical gender transition. Surgery and recovery had dominated my life for three years.
Although it has been a difficult journey, full of lots of pain and frustration, it has all been worth it. Now, in a body that reflects me fully, all of that time, pain and frustration has melted away, to replaced by pure joy and gender euphoria.
Reflecting on my journey
To mark the end of my transition, I decided to cover my graft scar with a tattoo. The tattoo was not only to cover the scar but also to honor my journey.
Additionally, as my mum died not long after I completed my journey, I chose to have some of her ashes added to the tattoo. Now we have both risen from the ashes and been reborn.
Graft healing and tattoo videos
I hope this blog has been helpful, please do let me know in the comments below!
Helpful Phalloplasty Resources
I have written a book detailing the entire process of phalloplasty from decision-making to completion. More info here.
A list of additional phalloplasty videos and blogs can be found in my content index If you would like to ask any questions or request some blogs or videos you would like to see, please send me a message.
I have additional video resources, showing a completed phalloplasty result on my Ko-fi page.
For any trans people exploring surgery options, or going through surgery, I offer email support and mentoring on a pay-what-you-can-afford basis. I am always happy to help.
Hello! My name is Finn and I have a passion for creating honest content, that inspires personal growth and promotes well-being.
Buy my Phalloplasty memoir here.
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