No operation (yet)
Are you still unsure about whether to have genital surgery? Are you currently unable or do not wish to undergo genital surgery? Or are you awaiting genital surgery? Even without surgery, there are things you can do to adapt your body that may reduce any gender dysphoria you are feeling. You’ll find information and tips on this on this page!
An Important decision
Opting for genital surgery is an important decision. Surgery has many consequences, these may be mental, physical, social and/or sexual. Genital surgery also carries risks. With any operation, minor or more serious medical problems (complications) can arise.
If you’re considering genital surgery, it may help to think about the impact your genitals have on your gender identity and your identity more generally. What do you think or hope genital surgery might mean for you? Is it a choice that will suit your life as it is now? Can you count on support from friends and family? Genital surgery has both many advantages and disadvantages. It is therefore perfectly normal to have doubts about genital surgery. This does not mean that you have doubts about your gender identity. It is important that you take the time to weigh up your decision carefully and discuss it with your loved ones and healthcare professionals.
There are several feminising genital surgeries you can choose from. You can also choose not to have surgery.
Changing your official gender without genital surgery
Since 2014, Dutch law allows you to change the gender on your birth certificate without undergoing genital surgery.
Non-medical option: ‘Tucking’
To reduce or conceal the appearance of your penis some use a technique called ‘tucking’. This is where the penis is positioned towards the anus and the testicles are pushed upwards. When ‘tucking’, it is best to use medical tape to minimise damage to the skin. Shaving the area beforehand can help the tape stick better. There are also special tucking underwear (gaffs/dance belts) which help to keep the genitals in place; you can find these in theatre supply shops or online (at for example, from UNTAG or Paxsies).
On YouTube you’ll find all sorts of videos explaining different ways of tucking.
It is possible that prolonged ‘tucking’ may impair sperm quality. You can find more information about preserving fertility and fulfilling your desire to have children here. In addition, tucking may cause skin problems over time. Discuss this with your treating doctor.
Hair removal
Body hair can be removed in various ways (temporarily or permanently): shaving, waxing, epilation, electrolysis (electrical hair removal) or laser treatment. Hair removal creams are an option for temporarily removing body hair but may cause irritation. Very occasionally, it is necessary to permanently remove hair from part of the genital area prior to a vaginoplasty or vulvoplasty. You can read more about this in the section on preparing for genital surgery..
Hormone treatment
Some trans and gender-diverse people are prescribed medication to delay puberty (puberty blockers). If you take puberty blockers from early puberty onwards, your genitals will be underdeveloped, meaning you will have less skin in the genital area. This can affect the technique a surgeon may use later for a possible vaginoplasty. You can find more information about vaginoplasty and the surgical techniques here.
Hormone treatment causes physical changes. Some effects of hormone treatment are permanent, such as breast growth and possible infertility. The extent of the changes and how long it takes for you to notice them varies from person to person and depends on your genes, your dosage and how long you have been receiving hormone therapy: the longer you use hormones, the more permanent the changes will be. As well as reduced fertility, hormone treatment can cause physical changes in:
- Fat and muscles: you will gain more fat around your hips and thighs. Your muscle mass will decrease.
- Breast growth: within 2–3 months, your breasts will start to grow. Touching them may be painful. Recent research shows that one year of hormone treatment leads to an average cup size of AAA. Breast enlargement operations, if desired, are only possible after 12 to 24 months of hormone treatment.
- Face: subcutaneous fat increases, contributing to a more feminine facial shape. This process can take up to three years, so it is advisable to wait before having any facial surgery.
- Body hair: body hair becomes thinner, softer and grows more slowly.
- Fertility: The use of hormones, to the best of our current knowledge, can have a negative effect on sperm. If you wish to have sperm frozen at a later moment in time, you will need to temporarily stop taking hormones.
For some trans and gender-diverse people, hormone treatment is sufficient to alleviate feelings of gender dysphoria. You may therefore choose not to undergo genital surgery (yet).
Sexual activity
Sexual activity is important to many people. Your sex life does not depend solely on genital surgery, but also on many psychological and biological factors. It is therefore, a good idea to think about what you want from sexual activity and how this may relate to your genitals and genital surgery. You can find more information about sexual activity on this page.
This text was edited on 3-11-2026
Next Step
We recommend that you go through all the information chapters step by step to get a complete picture of the various treatment options and the process involved!We strive to keep this information up to date. Do you have any additions or comments regarding the information above? Please email us at [email protected]
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Fertility
Are you considering genital surgery? It’s important to think in advance about whether you might want to have children and about preserving your fertility.
