FTM Metoidioplasty Surgery in Thailand (FTM Bottom Surgery)

Metoidioplasty works with what your body has already begun. After testosterone therapy enlarges the clitoris, this procedure releases it from surrounding tissue and repositions it to create a small but naturally sensate phallus. The result is a penis constructed entirely from your own erectile tissue, capable of natural erection, and in many cases, standing urination, without the complexity or donor-site scarring of phalloplasty.

Procedure 3–5 hours

Hospital Stay 3–5 nights

Recovery 6–8 weeks

Minimum Stay 14–21 days

What Is FTM Metoidioplasty?

Metoidioplasty takes advantage of the clitoral growth that occurs during testosterone hormone therapy, typically after a minimum of one to two years of treatment. The hormonally enlarged clitoris (meta-clitoris) is released from the suspensory ligament and surrounding tissue, straightened if necessary, and repositioned to project outward like a natal penis. Because the tissue is already erectile and densely innervated, the resulting neo-phallus retains full erogenous sensation and the ability to become erect naturally.

Depending on your goals, metoidioplasty can range from a straightforward clitoral release to a comprehensive reconstruction that includes urethral lengthening (to enable standing urination), scrotoplasty (creation of a scrotum using labial tissue, with optional testicular implants), and vaginectomy (closure of the vaginal canal). Each of these components is discussed during consultation to build a surgical plan that matches your individual priorities. As with all genital gender-affirming procedures, WPATH Standards of Care (SOC 8) documentation is required.

Common Concerns FTM Metoidioplasty Can Address

Dysphoria related to the appearance and size of external genitalia
Desire for a naturally sensate, erectile phallus without donor-site scarring
Frustration with the inability to urinate while standing
Preference for a less complex procedure than full phalloplasty

Are You a Good Candidate?

At least 12 months (ideally 2+ years) of testosterone therapy for adequate clitoral growth
Persistent gender dysphoria with two referral letters per WPATH SOC 8
Realistic expectations about achievable phallus size (typically 4–8 cm)
Good overall health and free from uncontrolled medical conditions

Techniques & Options

Metoidioplasty is highly customisable, and the extent of the procedure depends on your individual goals. Clitoral growth, tissue quality, and urethral anatomy are assessed during consultation to determine which components are appropriate. The options range from a simple release to a full reconstruction.

Three levels of metoidioplasty are offered:

Simple Metoidioplasty (Clitoral Release)

The clitoris is released from its suspensory ligament and surrounding tissue to maximise its visible length and projection. No urethral lengthening or scrotoplasty is performed. This is the simplest and fastest option, with the shortest recovery time, and is well-suited for patients who want increased projection without additional complexity.

Shortest operative time and fastest recovery
Full erogenous sensation and natural erection preserved
No urethral complications as the urethra is not modified

Ring Metoidioplasty

In addition to the clitoral release, the urethral plate is extended using local tissue to allow the urethra to reach the tip of the neo-phallus. A ring of vaginal mucosal tissue is used to provide additional coverage. This enables standing urination while keeping the surgical complexity moderate.

Enables standing urination through the tip of the neo-phallus
Uses local tissue with no distant donor site required
Moderate surgical complexity with manageable recovery

Full Metoidioplasty with Scrotoplasty

The most comprehensive option combines clitoral release, urethral lengthening, scrotoplasty (creation of a scrotum from labia majora tissue), and optional vaginectomy. Testicular implants can be placed in the neo-scrotum for a masculine contour. This approach provides the most complete genital reconstruction achievable with metoidioplasty.

Complete masculine genital appearance with scrotum and phallus
Standing urination and natural erectile function
Option to include vaginectomy and testicular implants in a single stage

Recovery Timeline

Days 1–3

You will remain in hospital with a urinary catheter in place. Moderate swelling and discomfort in the genital area are managed with oral pain medication and ice packs. Bed rest is recommended, with gentle walking from day two to promote circulation.

Week 1–2

The catheter is typically removed after 7–14 days once urethral healing is confirmed (timing depends on whether urethral lengthening was performed). Follow-up appointments check wound healing and urinary function. Swelling continues to decrease and bruising fades.

Weeks 2–4

You can resume light daily activities and gentle walking. Avoid strenuous exercise, heavy lifting, and direct pressure on the surgical area. Sutures dissolve during this period. If scrotoplasty was performed, the neo-scrotum continues to settle and heal.

Weeks 4–8

Most patients return to work and daily routines by week 6. Sensation is already present and continues to refine. Exercise can resume gradually once your team confirms you are ready. The neo-phallus settles into its definitive shape and contour over the following 3–6 months.

What to Expect

Natural Erection Erectile tissue preserved for spontaneous function

Full Sensation Erogenous nerve supply intact from the start

Standing Urination Achievable with urethral lengthening options

Safety & Risks

Metoidioplasty is less complex than phalloplasty, but as with all surgical procedures it carries potential risks. The risk profile varies depending on whether urethral lengthening and scrotoplasty are included, and each risk is explained in the context of your specific surgical plan.

Urethral fistula (if urethral lengthening is performed)
Urethral stricture requiring dilation or revision
Wound dehiscence or delayed healing
Haematoma or excessive swelling

Cosmetic dissatisfaction with neo-phallus size or appearance
Infection at the surgical site (uncommon)
Testicular implant displacement or extrusion (if placed)

Urethral complications are the most common issue when urethral lengthening is included. A simple metoidioplasty without urethral modification carries a significantly lower complication rate. Weighing the benefits of standing urination against the additional surgical risk is a key part of the pre-operative discussion.

How Much Does FTM Metoidioplasty Cost in Thailand?

Our pricing is transparent and all-inclusive, and your quote covers everything from surgeon fees to hospital stay.

FTM Metoidioplasty

All-inclusive surgical package

From $6,000

Board-certified surgeon fee
Anaesthesia & operating theatre
Hospital stay & nursing care

Post-operative medications
Follow-up appointments
Dedicated care coordinator

Choose Your Recovery Hotel

Comfortable accommodation with breakfast, transfers & round-the-clock care team access

From $89 / night

Spacious suites on Sukhumvit Soi 23 with kitchenette, daily breakfast, pool and gym access. Well-placed for hospital visits and ideal for longer recovery stays — private, comfortable, and easy on the budget.

Serviced apartments in central Sukhumvit with full kitchen, in-unit laundry, pool and fitness centre. A genuine home-away-from-home for patients recovering over several weeks — popular with those planning multi-stage procedures.

Five-star luxury near Bangkok's medical quarter, renowned for flawless Japanese-inspired hospitality. Generous rooms, a full-service spa, and 24-hour in-room dining — for patients who want an exceptional recovery experience.

Common Questions About FTM Metoidioplasty

Everything you need to know before your procedure

The size of the neo-phallus depends on how much clitoral growth has occurred during testosterone therapy. Most patients achieve a phallus length of 4–8 cm (approximately 1.5–3 inches). Adequate testosterone exposure for at least one to two years before surgery maximises growth potential.

Standing urination is possible if urethral lengthening is included in your procedure. Success rates for standing urination vary, and some patients experience urethral complications that may require minor revision. Without urethral lengthening, standing urination is generally not achievable.

Metoidioplasty creates a smaller phallus from your own clitoral tissue, with natural erection and sensation but limited size. Phalloplasty constructs a larger, full-sized phallus using tissue from the forearm, thigh, or back, but requires multiple stages, donor-site scarring, and an erectile prosthesis for rigidity. The choice depends on your priorities.

Yes. Many patients choose metoidioplasty as a first step and may pursue phalloplasty later if they desire a larger phallus. Having had metoidioplasty does not prevent future phalloplasty, though it may affect the surgical approach depending on what was done.

We recommend 14–21 days depending on the complexity of your procedure. A simple metoidioplasty requires a shorter stay, while full metoidioplasty with urethral lengthening and scrotoplasty requires closer to 21 days for catheter management and wound checks.

No. Vaginectomy is optional and depends on your personal preference. Some patients choose to retain the vaginal canal, while others prefer closure. Discuss this with your surgeon during consultation so they can plan accordingly.

Yes. Adequate testosterone therapy is essential for maximising clitoral growth before metoidioplasty. Most surgeons recommend a minimum of 12 months and ideally two or more years of testosterone therapy. Growth is assessed during the pre-operative consultation to confirm readiness.

Yes. Because the procedure uses your existing clitoral tissue with its full nerve supply intact, erogenous sensation is preserved. The vast majority of patients retain the ability to achieve orgasm after metoidioplasty.

Yes. Under WPATH Standards of Care (SOC 8), metoidioplasty typically requires two independent referral letters from qualified mental health professionals. Our care team can guide you through the documentation process.

If biological parenthood is important to you and hysterectomy or oophorectomy is planned as part of your surgical journey, egg or embryo freezing should be completed beforehand. Our care team can help arrange fertility preservation services.

Yes. Many patients choose to have a hysterectomy performed at the same time as metoidioplasty, or as a separate prior procedure. The timing and approach are discussed during consultation.

Your quote covers the surgeon's fee, anaesthesia, operating theatre, hospital stay and nursing care, post-operative medications, catheter supplies, and follow-up appointments during your stay. Testicular implants, if desired, may be quoted separately. Flights and accommodation are arranged independently.

Dr. Kanokwan Pattanaporn

MEDICALLY REVIEWED

Dr. Kanokwan Pattanaporn

MEDICALLY REVIEWED

Gender Affirmation Surgeon · Bangkok

Last reviewed: February 24, 2026

Medical References

Medical disclaimer: Content on this site is provided for informational purposes and should not be treated as medical advice. Outcomes, timelines, and eligibility differ from person to person. Speak with an experienced gender-affirming surgeon before proceeding with any procedure.

What's Included

Board-certified surgeon fee
Anaesthesia & operating theatre
Hospital stay & nursing care
Post-operative medications
Follow-up appointments
Dedicated care coordinator

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FTM Metoidioplasty Surgery in Thailand

What Is FTM Metoidioplasty?