FTM Gender Confirmation Solutions: Understanding Your Treatment Options

A wide variety of plastic surgery procedures are available to assist transgender individuals in their gender confirmation experience.

MTF Gender Confirmation Solutions Overview - 1135

The Skinny

Gender confirmation surgery or gender reassignment surgery can be a major component of a transgender individual’s transition. There are numerous surgical procedures from head to toe for male to female (MTF) transgender patients. Plastic surgery procedures are typically used in conjunction with medical and hormone therapies being administered under the care of a medical provider. You can also consult our female to male (FTM) gender confirmation guide.

All individuals undergoing a gender confirmation or gender reassignment transition are evaluated for mental health, emotional health, and physical health. This is to provide whole patient consideration and maintain standards of care for transgender health and gender dysphoria. Numerous international and national organizations exist to advocate, educate, and create a transgender community. The World Professional Association for Transgender Health (WPATH), American society offshoot USPATH, and GLAAD are some of these institutions.

The Specifics

Who is a candidate for male to female (MTF) gender confirmation surgeries?

Candidates for gender confirmation surgery are individuals identified as male at birth who are seeking to fully embody their authentic female gender identity. The decision to pursue medical and/or surgical treatments as part of the transition journey is entirely unique to every individual transgender person. Anyone considering a gender confirmation surgery should consider their overall health, expectations of the procedure, and ability to commit to recovery times prior to pursuing treatments.

What can you expect from male to female gender confirmation surgeries?

MTF gender confirmation surgeries vary significantly depending on an individual transgender candidate’s needs. There are both surgical and non-surgical procedures for gender reassignment.

  • Facial Feminization: These procedures address the hair, face, and neck. There are surgical options to alter bony and soft tissue structures. There are also non-surgical options like fillers, thread lifts, and Botox.
  • Transfeminine Top Surgery: Typically a surgical breast construction involving implants or fat transfer. The nipples and areola are also usually addressed to create a female breast.
  • Transfeminine Bottom Surgery: These are usually surgical procedures to alter the hips, buttocks, legs, and genitals.
  • Body Contouring: Liposuction is a minor surgical procedure, although other body contouring procedures may be less invasive and involve phototherapy or freezing techniques.

Surgical options are more involved, but also more permanent, and will involve weeks to months of recovery. Non-surgical procedures typically provide less permanent results, but are also less invasive, and possibly changeable. Certain hair procedures may take years to achieve full, lasting results. Medical and hormone therapies may affect surgical procedures and so should be discussed with your providers.

When should you consider male to female gender confirmation surgeries?

The decision to pursue gender confirmation surgeries is unique to every individual transgender patient. Considerations for mental health and physical health are highly important components of the appropriate time to pursue procedures. Additionally, candidates undergoing medical and hormone therapies will need to discuss the possibility of surgical procedures with their plastic surgeon and medical provider.

What is the youngest age someone can have male to female gender confirmation surgeries?

Guidelines for pediatric individuals (those under age 18) pursuing gender affirming surgeries recommend that transgender candidates do not undergo genital reconstruction procedures including phalloplasty (penile construction), scrotoplasty (scrotum construction), vaginoplasty (labia, clitoris, and vaginal construction), oophorectomy (ovary removal), or hysterectomy (uterus removal) until they are 18.

Certain top procedures can be considered around age 16. A discussion with a certified medical provider is important in determining the most appropriate timing of all gender affirming procedures and therapies. Additionally, parental consent and complete physical and mental health evaluations will be necessary.

Facial Feminization Procedures

A combination of surgical and non-surgical procedures that address the forehead, hairline, nose, lips, cheeks, chin, neck, and more may be employed for facial feminization.

Forehead Contouring & Hairline Advancement

Eyelash & Eyebrow

Hair Removal


Cheek Augmentation

Lip Augmentation

Chin Surgery

Neck & Jaw Procedures

Transfeminine Top Procedures

Breast augmentation via implants, fat transfer, or some combination of the two is the goal of transfeminine top procedures.

Transfeminine Bottom Procedures

Transfeminine bottom procedures can be used to remove male sex organs and create a vagina, clitoris, and labia.

Body Contouring

There are both surgical and non-surgical treatment options to shape and contour the body.

The Takeaway

For transgender individuals considering incorporating gender confirmation surgeries into their transition, there are a myriad of available procedures to further refine, define, and idealize their desired aesthetic. A plastic surgeon can assist with both sex reassignment surgeries and cosmetic transgender surgeries in conjunction with medical and hormone therapies from a healthcare provider. Candidates should also consider discussing with their insurance companies possible coverages for some of these procedures in the treatment of gender dysphoria.

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