Non-Binary Options For Metoidioplasty
People who identify as non-binary represent a substantial and growing population within the LGBTQ community. Historically, gender-affirming bottom surgery has been binary in nature: Female to Male or Male to Female. However, there's an increasing number of surgeons who offer an individualized approach to Metoidioplasty for non-binary people seeking bottom surgery.
Vaginal Preservation With Metoidioplasty
A common myth about Metoidioplasty is that Vaginectomy is required but this is only partly true. If Urethral Lengthening is being performed, then most surgeons will require Vaginectomy to reduce urinary complications. However, if one opts out of Urethral Lengthening, then they can also choose to keep their vagina (as well as their uterus.)
Surgeons who will perform Metoidioplasty with Urethral Lengthening and without Vaginectomy include Dr. Curtis Crane and Dr. Richard Santucci in Austin TX, and Dr. Daniel Freet in Houston TX.
In the Simple Release procedure, the clitoris is freed from surrounding tissue, increasing the length and exposure of the phallus. The native urethral opening and vagina are left in place. Scrotoplasty and Testicular Implants are optional.
Vaginectomy also isn't performed in the Ring Metoidioplasty procedure but the vaginal opening is partially closed. When it was first described in 2009, Ring Metoidioplasty included Urethral Lengthening however some surgeons don't offer UL with Ring Meta. Scrotoplasty and Testicular Implants are optional.
While not often done in FAAB people, Nullification can be achieved through a combination of Vaginectomy and Perineoplasty, or removal of labia, and burying of the clitoris. If Vaginectomy is performed, Hysterectomy is required.
Hormone Therapy Is Required For Metoidioplasty
Patients should have a minimum of 12-24 months of continuous use of Testosterone to optimize genital growth prior to surgery. It's important to note that going off Testosterone after Metoidioplasty could cause shrinkage of the phallus, making standing to void no longer possible and/or results less satisfying.
Not every Metoidioplasty Surgeon is comfortable offering non-binary options, but there's a growing number who are enthusiastic about providing truly inclusive care. An experienced Metoidioplasty Surgeon will work with you to create a treatment plan that is specific to you and your needs.
Last updated: 04/08/20