Preparing for a Sex Change

by Dr. Harold Reed

1. Male to Female

While the surgeries are the primary component of a gender reassignment surgery from male to female, there are a number of additional factors that also need to be considered beyond the procedure itself.  

Among the preparations that need to be made is electrolysis for hair removal. It is very important to get this completed a month or two before surgery and some hairs grow back (the 10% of the 10% of the 10%).  If you need a small touch up, we can do that before surgery.  Our experience seeing patients done at other centers is that "scraping" does not always work that well as the last thing patients want is for hair to grow out of the new vagina. 

I have been doing sex change procedures since 2002 and I have received training in Belgrade (Ghent) and Thailand, in addition to attending numerous seminars here and abroad.

On our web-site under are 2 articles that have appeared in peer reviewed journals.  We have over 1000 cases of experience and offer compassionate fees to assist in the affordability of the procedures for those who are living as best they can in these challenging economic times.

2. Female to Male - What to Expect from a Metoidioplasty

A metoidioplasty is essentially a form of female-to-male sex reassignment surgery, but it requires more than a doctor’s procedure to complete the results.   You will also need to undergo surgeries in advance, and will need to take part in various prepping efforts beforehand and will have a few strategies and decisions to make after the metoidioplasty is complete. 

Ideally you should have a bilateral salpingo-oophorectomy (removal of the tubes and ovaries (done by others) and a vaginally assisted hysterectomy (removal of the uterus) before metoidioplasty.  

Additionally you should ideally have closure of the vagina, not necessarily removal as that is a bloody and potentially complicated procedure.  We favor colpocleisis or obliteration of the vaginal canal.

Next you will want to maximize the clitoral length before metoidioplasty.  This can be accomplished both with intramuscular testosterone along with close hormonal surveillance (blood tests) by a knowledgeable doctor, as well as direct application (topical) of highly effective testosterone-like agents.  I would propose a good 2 or more inches of clitoral body including glans before surgery.

The surgery may be conducted at that point.  Later, you may wish to have testicular implants and there are photos you can view on our website.  My suggestion is do not go for overly large testicle implants because that will dwarf the appearance of your metoidioplasty result.

Please visit our website for several photos including a phalloplasty with a penile prosthesis (in the erect mode).  

Photos of our results are posted on


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