Men’s Vagina and your options

Yes, there are individuals who are assigned male at birth (AMAB) but identify as transgender women and desire to undergo gender-affirming genital surgery, which may include procedures such as vaginoplasty or gender confirmation surgery (often referred to as bottom surgery). These individuals experience gender dysphoria, which is a distressing disconnect between their gender identity and their assigned sex at birth.

Vaginoplasty is a surgical procedure that constructs a neovagina, which is a surgically created vaginal canal and external genitalia that closely resemble those of cisgender women. The procedure typically involves removing the penis, reshaping the scrotal tissue, and using various surgical techniques to create the neovagina. This surgery is a crucial part of the gender affirmation process for many transgender women, as it aligns their physical appearance with their gender identity.

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It’s important to understand that transgender experiences are diverse, and not all transgender individuals desire or pursue gender-affirming surgeries. Some may choose hormone therapy or other forms of gender-affirming care without surgery, while others may decide to pursue surgery as part of their gender transition.

Gender-affirming surgeries are medically and psychologically evaluated, and they are performed by skilled surgeons who specialize in transgender healthcare. The decision to undergo such surgeries is deeply personal and often involves careful consideration, counseling, and support from healthcare providers, therapists, and loved ones.

Respecting individuals’ choices regarding their gender-affirming care and supporting their access to appropriate medical care is essential in ensuring their well-being and mental health.

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Vaginoplasty, also known as gender confirmation surgery or bottom surgery, is a surgical procedure that is part of gender-affirming care for transgender women or individuals assigned male at birth (AMAB) who wish to have female genitalia that aligns with their gender identity. It is a complex and highly specialized surgical procedure that involves creating a neovagina, which closely resembles the external and internal structures of a cisgender woman’s vagina. Here are some key details about vaginoplasty:

The Procedure:

  1. Preparation: Before vaginoplasty, individuals typically undergo a thorough evaluation by a mental health professional and a medical evaluation by a gender-affirming healthcare team. These evaluations are essential to ensure that the individual is well-informed about the procedure, has realistic expectations, and is mentally and physically prepared.
  2. Anesthesia: Vaginoplasty is performed under general anesthesia, ensuring that the patient is asleep and does not experience pain during the surgery.
  3. Surgical Techniques: There are several surgical techniques for vaginoplasty, but the most common procedure is the penile inversion method:
    • The penis is carefully dissected and the erectile tissue is removed.
    • The scrotal tissue is reshaped to form the labia majora.
    • The glans of the penis is used to create the clitoral hood, and the urethra is shortened and repositioned.
    • A neovaginal canal is created by using the penile skin and other tissue grafts.
    • The neovagina is typically lined with mucous membrane or skin grafts to resemble the vaginal lining.
  4. Duration: The surgery can take several hours to complete, and the specific duration depends on the complexity of the procedure and the surgeon’s expertise.

Recovery and Aftercare:

  1. Hospital Stay: After the surgery, the patient may need to stay in the hospital for a few days for observation and initial recovery.
  2. Recovery Period: Full recovery from vaginoplasty can take several weeks to months. During this time, patients need to follow strict aftercare instructions provided by their surgical team.
  3. Dilation: Dilation is a crucial part of the post-operative care. Patients are typically required to dilate the neovagina regularly to prevent the surgical site from closing. Over time, the frequency of dilation decreases.


  • The results of vaginoplasty aim to create female genitalia that are anatomically and aesthetically similar to those of cisgender women.
  • The neovagina may provide sexual function and sensation, including the ability to achieve orgasm, although results can vary from person to person.

Risks and Considerations:

  • As with any surgery, there are risks associated with vaginoplasty, including infection, bleeding, scarring, and potential complications.
  • Vaginoplasty is a major surgical procedure, and it is essential for individuals to have a thorough understanding of the risks, benefits, and potential outcomes.

It’s important to note that not all transgender women choose to undergo vaginoplasty, and the decision to pursue this surgery is deeply personal. Additionally, transgender healthcare and surgical techniques continue to advance, providing individuals with more options and improved outcomes. Individuals considering vaginoplasty should consult with experienced gender-affirming surgeons and mental health professionals to make informed decisions regarding their care and transition.

The cost of vaginoplasty, like many medical procedures, can vary significantly depending on various factors, including the location of the surgery, the surgeon’s experience, the specific surgical technique used, the type of facility where the surgery is performed, and associated healthcare expenses. Here are some key points to consider:

  1. Variation in Costs: The cost of vaginoplasty in the United States, for example, can range from approximately $20,000 to $40,000 or more. However, prices can be lower in other countries or regions.
  2. Geographic Differences: The cost of vaginoplasty can vary from one country to another and even within different regions of the same country. In some cases, individuals may choose to travel to another location for surgery if they find more affordable options.
  3. Healthcare Systems: The presence of universal healthcare or government-funded healthcare systems in certain countries may impact the cost of vaginoplasty for residents, making it more accessible and affordable.
  4. Insurance Coverage: In some countries, health insurance plans may cover some or all of the costs associated with gender-affirming surgeries, including vaginoplasty. It’s important to check with insurance providers to understand coverage options.
  5. Surgeon’s Fee: The surgeon’s fee is a significant portion of the total cost, and it can vary based on the surgeon’s reputation, experience, and location. Highly experienced surgeons may charge higher fees.
  6. Facility Costs: The type of facility where the surgery is performed can influence costs. Some individuals may choose to have surgery in a hospital, while others may opt for surgery in an outpatient surgical center.
  7. Additional Expenses: In addition to the surgical procedure itself, there may be additional expenses, including anesthesia, hospital or facility fees, pre-operative and post-operative care, medical tests, and follow-up visits.

It’s important for individuals considering vaginoplasty to obtain detailed cost estimates and understand all the associated expenses before making a decision. It’s also advisable to consult with healthcare professionals and surgeons who specialize in transgender healthcare to explore the options available in their region and to ensure that the chosen surgeon is experienced and reputable.

While costs can vary, it’s crucial not to compromise on the quality and safety of the procedure to save money. Surgical outcomes and the overall experience can be influenced by the expertise and reputation of the surgeon and the quality of care received. Always prioritize safety and thorough research when considering any surgical procedure, including vaginoplasty.

The cost of vaginoplasty in Thailand can vary depending on several factors, including the specific surgical technique, the surgeon’s experience and reputation, the facility where the surgery is performed, and additional expenses such as anesthesia and post-operative care. However, Thailand is known for offering gender-affirming surgeries, including vaginoplasty, at a more affordable price compared to many Western countries.

As of my last knowledge update in September 2021, the cost of vaginoplasty in Thailand typically ranged from approximately $7,000 to $15,000 USD. It’s important to note that these prices are approximate and can vary based on individual circumstances and choices.

When considering vaginoplasty in Thailand or any other location, it’s essential to:

  1. Research Surgeons: Choose a surgeon who specializes in gender-affirming surgeries and has a good reputation. Read reviews, ask for recommendations, and review before-and-after photos if available.
  2. Consultation: Schedule a consultation with the surgeon to discuss your specific needs, expectations, and the costs involved. Ensure that the quoted price includes all necessary fees and expenses.
  3. Consider Additional Costs: In addition to the surgeon’s fee, consider other costs, such as anesthesia, hospital or facility fees, pre-operative and post-operative care, medical tests, and follow-up visits.
  4. Check Insurance: If you have health insurance that covers gender-affirming surgeries, check if it can be applied to procedures performed in Thailand.
  5. Travel and Accommodation: If you are traveling to Thailand for surgery, factor in the costs of travel, accommodation, and any necessary visas or documentation.
  6. Local Laws and Regulations: Be aware of any legal and regulatory requirements related to gender-affirming surgeries in Thailand, as well as any travel restrictions or COVID-19-related considerations.

It’s crucial to do thorough research, seek recommendations, and carefully review the details of any surgical package before making a decision. Additionally, consult with healthcare professionals who specialize in transgender healthcare to ensure that you receive appropriate care and support throughout the process. Keep in mind that prices may have changed since my last update, so it’s advisable to contact reputable surgical centers and healthcare providers in Thailand for the most current information.

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It’s important to clarify that biologically and anatomically, individuals assigned male at birth (AMAB) do not have vaginas. Vaginas are female reproductive organs, and their presence is a defining characteristic of female anatomy.

However, transgender women or individuals assigned male at birth who identify as women may undergo gender-affirming surgery known as vaginoplasty. Vaginoplasty is a surgical procedure that creates a neovagina, which is a surgically constructed vaginal canal and external genitalia that closely resemble those of cisgender women. The goal of vaginoplasty is to provide transgender women with a genital appearance that aligns with their gender identity.

A neovagina created through vaginoplasty can have a realistic appearance and function to varying degrees. The outcome depends on factors such as the surgical technique used, the skill of the surgeon, and individual variations in anatomy and healing.

Key points to consider regarding the realism of a neovagina:

  1. Anatomical Resemblance: Skilled surgeons aim to create neovaginas that closely resemble the external and internal structures of cisgender women’s genitalia.
  2. Sensation: Some individuals who undergo vaginoplasty report experiencing sexual sensation and pleasure in their neovaginas, including the ability to achieve orgasm. Sensation can vary from person to person.
  3. Aesthetics: The aesthetics of a neovagina can be quite realistic, with labia minora and majora that resemble those of cisgender women. Scarring and visibility of surgical incisions can vary.
  4. Functional Capabilities: Neovaginas created through vaginoplasty are capable of lubrication and self-cleaning mechanisms similar to cisgender women’s vaginas. However, they do not have the same reproductive functions.
  5. Dilation: After vaginoplasty, patients are typically required to engage in regular dilation exercises to maintain the depth and width of the neovagina and prevent it from closing. Dilation is an essential aspect of post-operative care.

It’s important to recognize that while vaginoplasty can create a neovagina with realistic features and functionality, individual experiences and outcomes can vary. Additionally, satisfaction with the results of the procedure can depend on personal expectations, goals, and the level of preparation and aftercare.

Transgender healthcare providers and experienced gender-affirming surgeons work closely with individuals to provide information, manage expectations, and ensure that individuals have realistic understandings of what vaginoplasty can achieve. The decision to undergo vaginoplasty is deeply personal and should be based on informed consent and the individual’s own gender-affirming goals.

The look of external genitalia, sometimes referred to as the “look” of a vagina, can be achieved without surgery through the use of clothing, padding, cosmetics, and other methods of body contouring. This is often referred to as “tucking” and is a common practice among transgender women or individuals who want to create a more feminine appearance in their clothing.

Here are some techniques and products that can help create the appearance of external genitalia without surgery:

  1. Tucking: Tucking involves concealing the male genitalia to create a flatter and more feminine appearance in the groin area. This can be achieved by pushing the testicles upward into the inguinal canals and positioning the penis in a way that minimizes its visibility. Tucking can be done using specialized undergarments, such as gaffs or tucking panties, which are designed to hold the genitals securely in place.
  2. Padded Underwear: Some individuals use padded underwear or shapewear with built-in padding to create the appearance of feminine curves in the hip and buttock areas.
  3. Clothing Choices: Selecting clothing styles that drape and flatter the body can help create a more feminine silhouette. A-line skirts, dresses, and clothing with ruching or draping can be particularly effective.
  4. Cosmetics: Makeup can be used to contour and highlight areas of the body to create the illusion of curves. Makeup artists often use shading techniques to enhance the appearance of cleavage, curves, and the waistline.
  5. Body Poses: Learning how to pose the body can make a significant difference in creating a more feminine appearance in photographs or when presenting in public.

It’s important to note that while these techniques can help create the appearance of external genitalia and a more feminine figure, they do not alter the physical anatomy of the body. If individuals desire a more permanent and anatomical change, gender-affirming surgeries like vaginoplasty may be considered, but these surgeries involve a different set of procedures and considerations.

The choice to use these techniques is a matter of personal preference, and individuals should feel free to express their gender identity and presentation in a way that is comfortable and authentic for them. Many transgender individuals use these methods to help alleviate gender dysphoria and feel more comfortable in their bodies without undergoing surgery.