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Where can you find reliable information about social and mental support? Read it here

Social and mental support

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Are you still in doubt about whether or not to have genital surgery, or are you on the waiting list? In the meantime, you can take certain steps towards your transition.

No operation (yet)

fertilization

Are you starting hormone treatment and/or genital surgery? Then it is important to first consider any future wish to have children of your own and to preserve your fertility.

Fertility

hair-removal

To be eligible for genital surgery, you must be well informed and meet a number of criteria. A summary of the various genital surgeries for masculinisation are described below, followed by the related criteria. 

Preparing for the genital operation

uterus

Hysterectomy is a gynecological surgery in which the uterus is removed. Read all about the treatment option on this page!

Hysterectomy (removal of the uterus)

vulva

Colpectomy is a gynecological surgery in which the vagina is removed. Here you can read all about the surgery and the recovery process.

Colpectomy (removal of the vagina)

penis

Below, you can read about the procedure, the risks of the operation and the period after the operation. The illustrations give you more insight into the surgical procedure itself.

Metoidioplasty

phallo

Phalloplasty is a surgery in which a penis is made with tissue from elsewhere in your body. The technique depends on your physical characteristics and desires.

Phalloplasty

proteses

After genital surgery for masculinisation, prosthetics can be placed. Prosthetic testicles are possible after metoidioplasty and phalloplasty. Erectile devices are possible after phalloplasty. 

Prosthetics after genital surgery

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Would you rather have your genital surgery abroad?

Abroad

We recommend that you go through all the information step by step to get a complete picture of the different treatment options and the process around them!

Next Step

Compare Treatment Options

In the choice compass, you can indicate how important you consider certain characteristics.

Choice Compass

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Making a decision for genital gender surgery can be complicated. The choice compass consists of 14 questions in which you can indicate which characteristics are important to you. The choice compass then indicates how these characteristics fit in with the different treatment options.* We recommend you to fill out the choice compass several times to get an objective result. The choice compass has to be filled out completely to see a result.

In Part 2 of the choice compass you will compare characteristics with each other. In order to get a complete picture of your needs, it is necessary to compare all characteristics with each other (even if they are not initially opposites of each other).

In Part 1 of the choice compass, you indicate how important you think a particular characteristic is on a scale of 0 to 100 (0 = not important, 100= extremely important).

a shorter recovery period and less risk of complications

not having to dilate for the rest of your life

a feminine appearance/demasculation of the genitals

being able to stop taking testosterone blockers

How important to you is having a deep vaginal cavity?

How important to you is not having to dilate for the rest of your life?

How important to you is being able to stop taking testosterone blockers?

How important to you is a feminine appearance/demasculation* of the genitals?

less or no risk of complications, such as losing part or all of the penis

How important to you is having a larger than average penis?

How important to you is your genitals being sensitive to touch?

How important to you is being able to urinate standing upright?

How important to you is being able to penetrate with the penis?

Something went wrong while processing the choice compass. Please try again!

What is the GenderAid?

About Us

What is the GenderAid and how can I use it? The video down below explains it.

The GenderAid

The compare tool lists pros and cons for each option.

Compare Tool

Content

Feminization

Masculinization

The comparator provides arguments for and against each treatment option in the words of peers

Step 2: Compare

Here, you can indicate which characteristics are important to you and see which treatment option best matches your preferences

Step 3: Choice Compass

On this page, you will find an overview of the information about feminizing and demasculinizing genital surgery

Step 1: Information

On this page, you will find an overview of the information on masculinizing and defeminizing genital surgery

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On this page, you will find the result of your completed Choice Compass. You can download or print the results. First, however, two short questions must be completed.

Questions

Download

You can complete the choice compass as many times as you'd like. Click here to start over

Start over

On this page you will find information about initiatives and organizations that can support you

Mental Support

Thank you!

Any (genital) surgery involves risks and recovery time.*Here, you can see how you rated the importance of these possible complications compared to the other clinical features.

A shorter recovery period

Some treatment options involve the creation of a vaginal cavity with depth.*Here, you can see how you rated the importance of having a vaginal cavity with depth,, compared to the other clinical features.

A deep vaginal cavity

It is necessary for some treatment options to dilate the vaginal cavity. This has to be continually performed. However, the frequency and duration varies per individual.*Here, you can see how you rated the importance of not being required to dilate in order to maintain the genitalia, compared to the other clinical features.

Not having to dilate for the rest of your life

The appearance of the genitalia depends on the available tissue and the technique used in creating the genitals.*“Demasculinization” of the genital area refers to the removal of unwanted biological genital characteristics. For example, removal of the testicles or removal of the penis.*“Feminization” of the genital appearance can be achieved by creating genitalia more similar to that of biological women.*Here, you can see how you rated the importance of changing the appearance of the genitalia, compared to the other clinical features.

A feminine appearance

With no surgery (yet), you have the lowest risk for complications and you retain your current genitalia.*It may be that you do not want to undergo genital surgery or that you are still unsure which treatment option is best for you. You may then choose not to have surgery (yet).

No surgery (yet)

The orchidectomy, has a lower risk of complications compared to the vulvoplasty and compared to the vaginoplasty.*Orchiectomy involves the removal of the testicles and is a relatively low-risk operation.*Since no vaginal cavity with depth is created, dilation is not necessary.*Due to the removal of the testicles, testosterone suppressant therapy may be stopped after surgery.

Orchiectomy

Some treatment options involve the removal of the testicles, stopping the production of testosterone. Subsequently, it is no longer necessary to take testosterone hormone suppressants.*Here, you can see how you rated the importance of being able to stop testosterone suppressant therapy, compared to the other clinical features.

Stop taking testosterone blockers

The vaginoplasty, has the highest risk of complications of all the treatment options.*In vaginoplasty, a vagina is created including a vaginal cavity with depth. The outer genital appearance is identical to the vulvoplasty.*Since a vaginal depth is created, it is required to dilate the vaginal cavity in order to maintain the genitalia.  *Due to the removal of the testicles, testosterone suppressant therapy may be stopped after surgery.

Vaginoplasty

The vulvoplasty, has a higher risk of complications compared to the orchidectomy. However, the risks are a lower compared to the vaginoplasty.*Vulvoplasty, involves the creation of a vagina without a vaginal cavity or depth. The outer genital appearance is identical to the vaginoplasty.*Since no vaginal cavity is created, dilation is not necessary.*Due to the removal of the testicles, testosterone suppressant therapy may be stopped after surgery.

Vulvoplasty

Op basis van jouw antwoorden kan er helaas geen eenduidig advies worden gegeven. We raden je aan om alle onderdelen van de website nogmaals zorgvuldig door te nemen en daarna de voorkeurswijzer opnieuw in te vullen.

Less or no risk of complications

Some treatment options leave the local genital tissue intact. This way, you retain the original tactile (sexual) sensation in the genital area.*Here, you can see how you rated the importance of maintaining this sensitivity, compared to the other clinical features.

Sensitivity to touch

The metoidioplasty without urethral lengthening, has a lower risk of complications compared to the metoidioplasty with urethral lengthening, as well as the phalloplasty surgeries.*Since, your own local tissue is used to create the penis, it is smaller in size compared to the phalloplasty penis. *However, this does allow you to retain the original (sexual) sensation of the genital area.*Furthermore, it is difficult to penetrate with the penis, or void standing up, without external prostheses.

Metoidioplasty without urethral lengthening

The metoidioplasty with urethral lengthening, has a higher risk of complications compared to the metoidioplasty without urethral lengthening. However, the risks are lower compared to the phalloplasty surgeries.*Since, your own local tissue is used to create the penis, it is smaller in size compared to the phalloplasty penis. *However, this does allow you to retain original (sexual) sensation of the genital area.*Furthermore, it is difficult to penetrate with the penis, or void standing up, without external prostheses.

Metoidioplasty with urethral lengthening

With no surgery (yet), you have the lowest risk for complications while retaining full sensation in the genital area. However, it is more difficult to be able to penetrate, or void standing up, without external prosthetics. *It may be that you do not want to undergo genital surgery or that you are still unsure which treatment option is best for you. You may then choose not to have surgery (yet).

Some treatment options involve urethral lengthening, so that you can void from the penis while standing.*Here, you can see how you rated the importance of being able to void while standing, compared to the other clinical features.

Standing upright urination

For some treatment options, penile prosthetics can be implanted in a supplementary operation. This penile implant then allows for you to penetrate with the penis.*Here, you can see how you rated the importance of being able to penetrate with the penis, compared to the other clinical features.

Penetration

The phalloplasty without urethral lengthening, has a lower risk of complications compared to the phalloplasty with urethral lengthening. *The penis is made from donor tissue. For this reason, phalloplasty has greater risks of complications compared to the metoidioplasty. *Because of this tissue, the penis is of a larger size compared to the metoidioplasty penis.*Since the penis is made from donor tissue, tactile (sexual) sensation in the genitalia will change.*At a later stage,  penile prosthetics can be surgically implanted, allowing for penetration with the penis.*Furthermore, it is difficult to void standing up, without external prostheses.

Phalloplasty without urethral lengthening

The phalloplasty with urethral lengthening has the highest risk of complications of all the treatment options. *It is possible to void standing up, but the urethral lengthening does greatly increase the risk of complications.*The penis is made from donor tissue. For this reason, phalloplasty has greater risks of complications compared to the metoidioplasty.*Because of this tissue, the penis is of a larger size compared to the metoidioplasty penis.*Since the penis is made from donor tissue, tactile (sexual) sensation in the genitalia will change.*At a later stage,  penile prosthetics can be surgically implanted, allowing for penetration with the penis.

Phalloplasty with urethral lengthening

The size of the penis depends on the available tissue and the technique used for creating genitals.*Here, you can see how you rated the importance of having a penis of a larger size, compared to the other clinical features.

Penis size

The figure below presents an overview of your treatment preferences for genital surgery.*This result concerns only the clinical (medical and physical) characteristics that differentiate between the treatment options.*These attributes in particular are good to discuss with your physician during the consultation for  genital surgery.*This result is based on your personal treatment priorities, as you have weighed the characteristics of the treatment options against each other in the Choice Compass. It may happen that you find certain features equally important, in which case these features will also have the same score in the figure. 

Characteristics

These questions are about your personal treatment wishes. This is separate from the results of the Choice Compass. Based on what you know and feel now, which of the statements below are consistent with your decision at this time?

Final Questions

Results

In the figure below presents an overview of the treatment options best suited to your treatment preferences. This is not a binding recommendation, but is intended to give insight into your own personal preferences in relation to the appropriate treatment options. The result is not decisive for your final treatment.*This result concerns only the clinical (medical and physical) characteristics when recommending the treatment options. Therefore, you may not agree with your outcome. *This result is based on your personal treatment priorities, as you have weighed the characteristics of the treatment options against each other in the Choice Compass.  It is therefore possible that several treatment options score equally as high in the figure.

Treatments

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No Operation (yet)

I will be able to have children the natural way

I do not need to decide now on whether or not I want to have children 

I will not need to prepare for any type of surgery 

I will not need to [permanently depilate](/masculinization/info/preparing-for-the-genital-operation#additional-preconditions-phalloplasty) my genitals 

I will not need to adjust my lifestyle to comply with the preconditions for the operations (re. smoking and BMI)  

My genitals will not have an aesthetically male appearance 

I will not be able to urinate standing up 

I will retain the current function of my genitals 

I have dysphoria / am repulsed by my genitals 

If I want to achieve a ‘bulge’, I will have to use[ prosthetics](/masculinization/info/no-operation-yet#non-medical-option-penile-devices-and-prosthetics)

I will not be housebound, so no one will ask any questions 

I can still experience sex like I'm used to with my current body

I maintain the ability to be penetrated vaginally and anally

If I want to penetrate, I can do so with tools (such as [a penile prosthesis or dildo](/masculinization/info/no-operation-yet#non-medical-option-penile-devices-and-prosthetics))

I will have more time to determine what I want

I can decide later on to have an operation

I will not face any of the health risks related to an operation 

I will not be ‘housebound’ for any length of time

Metoidioplasty without urethral extension

I will no longer be able to have children the natural way

Before the operation, I will need to consider [fertility preservation](/masculinization/info/fertility) and whether I would like to have children some day 

I can only have the operation if [my BMI is between 18 and 30](/masculinization/info/preparing-for-the-genital-operation#general-terms-and-conditions-of-genital-surgery)

I must [stop smoking](/masculinization/info/preparing-for-the-genital-operation#general-terms-and-conditions-of-genital-surgery)

I will be able to retain my vagina; a colpectomy is only compulsory in the case of urethral extension 

I will not need to [permanently depilate](/masculinization/info/preparing-for-the-genital-operation#additional-preconditions-phalloplasty) my genitals for the surgery

My penis will be smaller than in case of a phalloplasty 

The length of my penis will depend on the size of the clitoris

I will still be unable to urinate standing up 

I will have small scars in my genital region 

I will have a smaller than average penis 

I will have more ‘pants soiling’ than before the operation (but less than in case of  a phalloplasty) 

My penis may continue to grow after the operation

I will have to recover from my operation, which means people could start asking questions 

I will have more ‘pants soiling’ than before I the operation, but less so than would be the case with a phalloplasty 

There will be no noticeable scars on my body

The operation may change my genital sensation 

My below average sized penis usually means that penetration is not possible

It is likely that I will be able to have an orgasm 

My penis will be able to swell when I become aroused 

My penis will be made from my own genital tissue, which means that the erotic sensation is maintained

The operation is a physically drastic intervention 

My body will suffer less strain than would be the case with [phalloplasty surgery](/masculinization/info/phalloplasty)

Without urethral extension, my body is less likely to suffer [complications ](/masculinization/info/metoidioplasty#complications)

I will need less time to recover than would be the case with phalloplasty surgery

Metoidioplasty with urethral extension

First, I will need to have a [colpectomy](/masculinization/info/colpectomy-removal-of-the-vagina) before I can have a metoidioplasty with urethral extension 

The donor skin for the urethra will need to be [permanently depilated](/masculinization/info/preparing-for-the-genital-operation#additional-preconditions-phalloplasty)

There is a chance that I will be able to urinate standing up 

I will have conspicuous scars in certain places on my body that may cause people to ask questions 

I am going through a long process of operations, which means that, for a long time, I will need to depend on others to care for me 

The operation may change my genital sensation

My body is more likely to suffer [complications](/masculinization/info/metoidioplasty#complications) than would be the case without urethral extension 

Phalloplasty without urethral extension

The donor skin for the shaft of the penis will need to be [permanently depilated ](/masculinization/info/preparing-for-the-genital-operation#additional-preconditions-phalloplasty)

There will be scars in the area where skin has been removed (for the shaft of the penis)

I will have more ‘pants soiling’ than in case of a metoidioplasty 

I will have conspicuous scars on my arm/leg/side that may cause people to ask questions

I will have more ‘pants soiling’ than would be the case with a metoidioplasty 

I will not be able to have a natural erection 

I do not know what my sexual sensation will be after the operation (because the clitoris is then hidden under the skin)

It is likely that I will be able to have an orgasm since my clitoris can still be stimulated below the skin

I may be able to penetrate with the help of, for example,[ a penile prosthetic or tight condom ](/masculinization/info/prosthetics-after-genital-surgery) 

The operation is a physically drastic intervention, more so than would be the case with [metoidioplasty](/masculinization/info/metoidioplasty) 

Other areas of my body from which donor skin has been taken will also need to recover from the surgery 

Without urethral extension, my body is less likely to suffer [complications](/masculinization/info/phalloplasty#complications) 

Phalloplasty with urethral extension

First, I will need to have a [colpectomy](/masculinization/info/colpectomy-removal-of-the-vagina) before I can have a phalloplasty with urethral extension 

The donor skin for the urethra will need to be permanently depilated

There will be scars in the area where skin has been removed to create the shaft of the penis and the urethra 

I will be going through a long process of operations, which means that, for a long time, I will need to depend on others to care for me 

I may be able to penetrate with the help of, for example, [a penile prosthetic or tight condom](/masculinization/info/prosthetics-after-genital-surgery)

Compare Masculinizing Treatment Options

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