How do I go about starting to transition from female to male and keep my vagina? (photos)

Question

I want to look and sound like a man (facial hair, deep voice)I want to remove my breasts they sag from weight loss and at times are painful. I don't want a penis I want to keep that part of me female. I'm 21 and my best friend and fiance finally got me to accept this and I'm ready.

Jed H. Horowitz, MD, FACS · Answer

Top Surgery is the #reduction and masculinization of the breasts and chest for a person who wants a more #masculine chest.  This is often an individual who desires #gender reassignment. Breast tissue is #removed and the #nipple position is usually made smaller and then placed in a more masculine #anatomic #position.  Top surgery allows for a more #comfortable chest with improved psychosocial benefits. Clothing fits better, physical activity may be easier. The chest can also be made more masculine with fat #grafting or #implants to provide a more muscular and #sculpted #appearance. The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate.Hormone therapy for top surgery is not required unless you’re seeking coverage through #insurance. Many companies will require one year of HRT (Hormone replacement therapy). The #benefits of HRT for every patient, however, do include heavier #chest #muscles and more chest #hair; which can cover some incisions while you are healing. #HRT may be a strong consideration for most patients. WPATH (World Professional Association for Transgender Health) provides the best current standards of care for physicians to assist in the care of #transgender, #transsexual and #nonconforming patients.It's best to consult with your board-certified plastic surgeon about your concerns and to confirm if FTM Top is in your best interests.

Gary Lawton, MD, FACS · Answer

You would be an appropriate candidate for TOP surgery alone.  You are an excellent candidate for a double incision mastectomy with nipple graft.  You have to find a surgeon with experience in this area and thousands of great outcomes.  Look far and wide.  This is not a surgery that is taught in residency.  You may end up with a breast reduction if you choose the wrong surgeon. After that you can take T.

Babak Dadvand, MD · Answer

Hi cmcadoo1994,Thanks for the post. There are different phases in transitioning, from emotional to hormonal to surgical. To begin I would recommend seeking out a psychologist or therapist that has experience with transgender clients. This will begin the dialogue to prepare you for the emotional aspect of transitioning. In order to get the features you mentioned (facial hair, deep voice) you will require testosterone treatment. This is by prescription and should be under the supervision of a medical doctor as levels will need to be checked and doses adjusted. To remove the breasts I recommend you see a board-certified plastic surgeon who performs this surgery. This is not a breast reduction. It is chest masculinization and there are specific techniques that need to be performed to have a successful outcome. Sincerely,Dr. Dadvand

Sheldon Lincenberg, MD · Answer

Hello Mr. McAdoo,Most of my patients begin their transition by consulting with a trans-friendly psychologist who will likely have contacts with doctors in the community that can initiate hormonal therapy. You may also want to focus on fitness training that will build up your upper body muscles. You will begin to notice the effects of testosterone after a few months. At that time, you can look for a board-certified plastic surgeon who is known for his work with transgender patients.I hope that all goes well for you.

How do I go about starting to transition from female to male and keep my vagina? (photos)

Answers (4)

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