ABSTRACT
Genital surgery in male-to-female transsexuals may consist of several components, not all of which are requested by any individual patient. These are: bilateral orchidectomy, amputation of the penis, labioplasty, vaginoplasty, clitoroplasty. Bilateral orchidectomy is often requested by patients as a first stage prior to continuing to further genital surgery at a later date, but may in some patients be the only operation desired. Amputation of the penis is normally performed as part of labioplasty with or without vaginoplasty. Even if some of the skin is used for vaginoplasty, there is normally sufficient scrotal skin available after orchidectomy to permit the construction of labia. The penile skin may also be used in some areas, especially if it is not being used for a neovagina. Creation of a neovagina has two components: firstly the creation of a cavity for the vagina within the male pelvis/perineum, and secondly providing an epithelial lining for that cavity.
