They are, slowly (painfully slow). But no where near as quickly as MTF procedures, or any other medical procedures. I also agree with CntankerousUnagi "considering the med field cant be bothered..."

But there are a few good Doc's out there who are trying. Dr. Raphael recently (a few years ago) pioneered an improvement of sorts on the old meta procedure. less

I've stood in to observe one of Dr. Raphael's bottom surgeries and a couple of his top surgeries. He specializes in female to male surgeries; he does not even perform male to female surgeries because there are already plenty of surgeons who do them (and male to female surgeries are easier to perform).

I can tell you that Dr. Raphael truly is a passionate advocate for transgendered people. Unfortunately, however, the results of his surgeries vary widely from person to person, depending upon how well the person responds to hormones and how large the person's clit is to begin with. Some people's clits barely enlarge at all in response to hormones, so the end result looks childlike. But the main thing is that what the person sees in the mirror post-surgery FINALLY matches how (i.e., the gender) he feels inside; therefore, his patients who come to him are willing to risk having non-penetrating penises than to continue to live with genitalia that does not match their identities. At least the patient can finally urinate standing up as he feels he should be able to do.

One thing I wish to clarify at this point is that I am not advocating or encouraging anyone to seek out surgery. It is a big risk and each person must weigh out those risks to determine if surgery is worth it to him. If a potential female to male patient can attain pleasure from his genitals the way they currently are, I would caution that person to please realize that he will never be able to receive pleasure in that way again. As appealing as it may seem to possibly be able to have a penis that is capable of penetration, please realize that surgery CANNOT guarantee this. This type of surgery, like any surgery, comes with risks, and the outcomes of this type of surgery in particular is especially variable. (It is also incredibly expensive---about $25,000 or thereabout if I am not mistaken.)

Dr. Raphael told me that one patient's clit enlarged enough that he was able to form a very believable adult-sized penis. Several months after surgery, it was even functional as the patient was able to attain erections and have penetrative sex---but that was one particular patient who already had a large clit, which just happened to grow large enough to resemble a penis even before the surgery.

To make the new penis as long as possible post-surgery, Dr. Raphael instructs the patient to manually work with his new penis (with certain types of exercises) to keep the round ligament as elongated as possible as everything heals. (He cuts the round ligament in the groin area during his constructive surgery to use to flesh out and enlarge the girth of the new penis.)

But again, as I've already noted, not everyone's body responds the same way to the same surgery, unfortunately. Not every patient will have a functional penis that he can use for penetration.

I asked Dr. Raphael about other surgeons who use implants. He said there are just too many problems that can occur due to implanted foreign objects, particularly underneath thin, membranous skin. It is more the norm than not for the object to rupture through the skin, putting the patient at undue risk for a very, very serious and life-threatening infection.

I know if Dr. Raphael can think of a better and more effective way to do his surgeries, he will definitely pursue it. less

This is of fantastic help. I'm curious as to what you might think in regards to bottom surgery outlook for someone who was born with a micropenis that was 'normalized' to look like female genitalia. That is, an intersex person who has what would amount to a 'clit' that is roughly the size of, say, a large pea, with a shaft roughly an inch long.

I realize this is a bit graphic, but I'm very curious. less

I'm not a doctor, so I hesitate to say. When you say "'normalized' to look like female genitalia," does this mean the micropenis was surgically reduced in size? (I'm so hoping NOT!) If no surgery was performed on the micropenis, then it would be much, much easier to work with it.

If the person has normal levels of testosterone for a male, then taking male hormones is unlikely to have much of an effect, I would think. In other words, I am doubting that the micropenis would enlarge much, if any, in response to hormones. But if this person has been placed on female hormones, they would definitely need to be taken off of them. There is a possibility the penis MIGHT enlarge a little bit.

The round ligament that Dr. Raphael uses in his surgeries helps increase the girth. There really is not a whole heck of a lot he can do to increase length, though. (At least there are no known lengthening techniques with which he is comfortable from an ethical standpoint, given the extremely dangerous risks of infection posed by implants; he was pretty emphatic about that.)

I would encourage you to contact Dr. Raphael's office to ask. It's been a couple of years since I've watched his surgeries, and for all I know, he's developed (or is working on developing) a new technique that works better for him! He is certainly an innovative guy. (It's neither here nor there, but he is also a very cheerful and very funny guy, too!) less

When I was very small I (like many others) was put through unwanted surgery which is called 'normalization surgery'. My genitals were altered in attempts to make it look like female parts-- ie., butchered. I have been wanting to get things fixed (made male in appearance) my entire life, but given that it's a bit different than that of a transman, I've had a hell of a time finding any information on the subject.

I'm XXY, so I don't have a great deal of testosterone, but I imagine I have more than an XX individual. I've been told by a number of doctors that it's a risk to put me on hormones as my case is fairly unique and they don't really know how my body would respond.

Do you know where I could contact Dr. Raphael? Is there a website?

I truly appreciate the help, by the way. less

It's an unfortunate fact that the medical field just hasn't put in much effort. I really think things could improve (options, quality of surgery, prices, etc), but until the medical community is willing to see this as a serious issue, it's going to continue being very, very slow. less