MTF (male-to-female) vaginoplasty is gender-affirming surgery that creates female genitalia for transgender women. Surgeons use existing genital tissue, and sometimes other tissue grafts, to form both the vaginal canal and external structures like the labia and clitoris.
Types of Surgical Techniques
Penile inversion: most common. Uses penile skin to form the vaginal canal.
Penile inversion and scrotal graft: adds scrotal skin when more tissue is needed.
Intestinal vaginoplasty (colovaginoplasty): uses a section of the colon to form the vaginal lining.
Robotic-assisted peritoneal vaginoplasty: uses peritoneal lining (from abdomen) with robotic tools; newer method.
Benefits
Physical alignment with gender identity, alleviating dysphoria.
Ability to have penetrative sex; good erotic sensation is often preserved.
Improved hygiene and comfort.
Psychological and social benefits: better self-confidence, comfort in intimate and social situations.
What Are the Requirements?
Persistent gender dysphoria, formally diagnosed.
Usually need letters from mental health professionals.
Often required: at least 12 months of hormone therapy.
Must be of legal adult age (≥18yrs for most surgeons).
Health checks to ensure the person is medically safe for surgery.
If you want a surgery referral letter from us, we'll help with the assessment. You'll also need to have a conversation with your surgeon before the surgery.
What Happens During the Surgery
Takes about 4-8 hours under general anaesthetic.
Key steps include: creating the vaginal canal, forming external genitalia (labia, clitoris), repositioning urethra.
Hospital stay usually around 3 nights.
Recovery & Aftercare
First few weeks: pain management, wound care, limited movement.
Weeks 3-6: swelling goes down, begin dilation, gradually return to more activities.
Months 2-6: more healing, sexual activity becomes possible around month 3-4, depending on healing.
Up to a year for full recovery.
Aftercare: Dilation
Dilation is one of the most important parts of aftercare. It helps maintain vaginal depth and width. At first, dilation must be done frequently, then less often over time, but many people continue a long-term schedule.
Risks & Possible Complications
Common risks: bleeding, infection, slow healing, scarring.
More specific risks:
vaginal stenosis (narrowing)
urethral problems (urination issues)
problems with sensation (might be change, reduction)
Serious but rare risks: blood clots, fistulas (abnormal connections), complications from anaesthesia, injury to bowel in some methods.
Costs & Access
In the UK private sector: roughly £15,000-£30,000 depending on surgeon, technique, and hospital.
NHS funding may be possible through Gender Identity Services, but waiting times tend to be long.
Choosing your Surgeon
We have a list of recommended surgeons here.
We always recommend thoroughly researching the best professionals for your surgery. Look up the name of the surgery you are seeking, your region, and the names of surgeons you've heard of. Visit their websites and gather as much information as possible. Choosing a surgeon is important, so make sure that when you have a consultation or seek second opinions, you feel completely confident in the surgeon and the services they offer.
If you feel ready, you can book a Surgery Referral session with us to help you with the next steps. You can read more about surgery referral sessions here.
Emotional, Psychological, & Ongoing Support
Have realistic expectations is important. Recovery takes time, and having realistic expectations makes it easier to adjust. Therapy, peer support groups, and talking with others who have had the surgery can provide reassurance and encouragement throughout the process.