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Transgender vaginoplasty

This medical option is a kind of bottom surgery that involves the creation or reshaping of the vagina. Vaginoplasty is sometimes performed to revise vaginal anomalies and congenital conditions such as absence of a vagina at birth, as well as to repair the area following disease or injury.

As with other procedures, like plastic surgery of the nose (rhinoplasty), vaginoplasty may be undertaken for functional reasons, aesthetic reasons, or a combination of the two.

Vaginoplasty evokes very strong emotional responses (both pro and con) far more often than more common procedures like rhinoplasty. There is considerable controversy regarding surgery on some patients, notably children with “ambiguous genitalia” who have no pressing medical or functional need.

In some jurisdictions, bottom surgery like vaginoplasty is required by law in order for trans people to make legal changes to identity documents.

Surgical options

Inversion vaginoplasty

The oldest and most common vaginoplasty technique performed on women in our community uses tissue from the existing genitalia to create the vagina. It is sometimes called penile inversion. In some cases the lack of genital tissue may require additional skin grafts taken from the buttocks or near the hip bones. Some surgeons do a one-stage procedure where the vagina and external genitalia (vulva) are shaped at the same time. Other surgeons use a two-stage procedure which includes a labiaplasty at a later time.

Bowel vaginoplasty

A more complicated procedure uses a segment of colon to create the vagina. It is sometimes called a colovaginoplasty. It may be performed if there is very little existing tissue to use, although the complexity of the procedure, the higher complication rates, and the possible unwanted side effects make it a less preferable option in many cases.


Others choose a vulvoplasty, also called a zero-depth vaginoplasty, instead of a traditional vaginoplasty. This shapes the external genitalia into a vulva but does not include a vagina.

Phallus-preserving vaginoplasty

Some people in the salmacian community seek what some call bigenital procedures. This kind of phallus-preserving vaginoplasty preserves some or all of the existing genitalia and adds a vaginal opening in the perineum between the penis and anus. The goal of this procedure is to have both a sexually functional vagina and penis.

Related procedures

Some people in our community choose bilateral orchiectomy prior to or instead of vaginoplasty.

A labiaplasty involves reshaping the external genitalia and can either be done at the same time or as part of a two-stage operation a few months apart.


When performed on women in our community, the procedure has been given many suggested names over the years:

  • sex reassignment surgery (SRS)
  • sexual reassignment surgery
  • sex change operation
  • “the operation”
  • genital reassignment surgery
  • genital modification
  • genital plastic surgery
  • gender reassignment surgery (GRS)
  • genital reconstruction surgery
  • genital repurposing surgery
  • gender reinforcement surgery
  • gender affirmation surgery
  • gender confirmation surgery
  • gender affirming vaginoplasty (GAV)

These terms each have nuances in meaning that are simultaneously useful and problematic (to be discussed at length in the future). To avoid these semantic and political issues, this section uses the medical term for this procedure except when citing the works of others.


North America

See also: Transgender surgery in the United States


  • James Bellringer (London, UK)
  • Paul Jean Daverio (Potsdam, Germany)
  • Michael Krueger (Potsdam, Germany)
  • Jesús Sáenz de Cabezón y Chico (Barcelona, Spain)
  • Jorge Sáenz de Cabezón y Martí (Barcelona, Spain)
  • Timothy Terry (University Hospital, Leicester
  • Philip Thomas (Hove/Brighton, UK)
  • Jiří Veselý (Brno, Czechoslovakia) [website]


No longer active

See historic gender surgeons.


This section of Transgender Map is dedicated to the fond memory of Fran Kern. Fran was a personal assistant for recovering patients of Dr. Toby Meltzer. Fran passed away on December 24, 1998. Those whose lives she touched with her caring and compassion will not forget the kindness that emanated from her.

Disclaimer: This is medical talk, not medical advice. Some of this may not apply to you. It is presented without warranty. It may contain errors or omissions. You must do your own research.