This Video Shows How Male-to-Female Sex Reassignment Surgery Really Works

From start to finish, here’s how surgeons perform the procedure:

• The scrotum is cut down the middle, and each testicle is removed.
• The skin of the penis is cut and pushed to the base.
• The head of the penis is sliced (but not fully removed) and pulled back, and the inside of the penis is removed.
• The penile skin is inverted, and incisions are made to create a clitoris and urethral opening.
• The head of the penis is reduced to the size of a clitoris and reinserted.
• A vaginal opening is formed by inverting the area where the scrotum used to be.
• Skin from the scrotum is used to create labia.

Research has shown that most patients are able to have a healthy sex life after sex reassignment surgery (also known as gender confirmation surgery) and can even orgasm.

Gender confirmation surgery is just one step in the process of transitioning from a man to a woman, however—there’s counseling, breast augmentation surgery, hormone therapy, and more involved. The surgery, if elected, is usually one of the final steps.

There is also a similar surgery available for transgender men, in which a small penis is typically constructed by stretching out the clitoris.