Q: Can you pick your size?

A: Yes and no. You can give your surgeon your goals and they can do their best to achieve them but it’s impossible to guarantee. Your size largely depends on your anatomy, including blood vessels and donor site dimensions (ex wrist circumference for RFF). Good blood supply is really important for phallo, and anything above six inches can be hard to achieve, though sometimes possible.

Q: Can you feel it?

A: Usually yes. The amount of sensation a person has depends on the donor site and how that person heals/how their nerves regenerate. Sensation can take a long time to develop too, nerves take a long time to regenerate.

Q: Who’s the best surgeon?

A: There are many good surgeons out there, and a handful of very iconic ones in the phalloplasty community. But the best? That’s subjective. Everyone has different needs and requirements. Look up surgeons near you/in a place you’re willing to travel.

Q: Does it look like a natal penis?

A: This is another loaded question. Some trans people want a dick that is as close as possible to a natal dick. Which is fine, you have the right to your own goals and needs. But it’s also super important to remember that just because it’s not cis, doesn’t mean it’s less than. A penis is a penis, regardless of where it came from. But to actually answer the question, it’s possible. It depends on your own standards and how people scar, amongst other things. Medical tattooing is also an option to add detail and coloration similar to natal penises. And there’s a lot of diversity in natal genitalia and people have complicated feelings about their bodies. Cis men also often struggle with aesthetics, size, and functionality. Erectile devices were originally made for cis men with erectile dysfunction.

Q: Can it get hard?

A: Yes, though not unassisted. Phallo penises don’t have erectile tissue so they won’t get hard on their own, instead people have the option of getting an erectile device implanted or using an external erectile device. The two implant types are a pump and a semi rigid rod. The pump is just what it sounds like; an inflatable tube is placed inside the shaft and anchored to the pubic bone, the pumping part is oblong and placed inside one side of the scrotum, taking place of a testicle. The semi rigid rod is a rod that can be bent to allow for penetration. Both need to be replaced after several years. There are a lot of different external devices too, a popular one is the Elator.

Q: Is there a way to be uncircumcised?

A: There’s currently no way to mimic the texture of foreskin, though you can skip glansplasty and even get medical tattooing to give the appearance of foreskin and folds.

Q: Can you get meta first?

A: Yes. Meta (short for metoidioplasty) releases a suspensory ligament to free up the T dick and can often include urethral lengthening and scrotoplasty. Some surgeons do meta with UL as part of stage one of phalloplasty. But if phallo is your ultimate goal, I would speak to your surgeon first about getting meta before hand.

Q: Do you need to get a vectomy?

A: No, but some surgeons require it for UL.

Q: Can you get just phallus creation?

A: Yes, you can get any combination of things. Phallus creation with scrotoplasty and no burial, phallus creation without scrotoplasty or glansplasty, etc etc. Some surgeons do require vectomy if you get UL, burial if you get UL, or scrotoplasty if you get an erectile pump.

Q: Can you get top surgery and bottom surgery at the same time?

A: Not usually, but some surgeons do. The reasons it’s not usually done is as follows: Both halves of your body will be out of order. And you want to be able to rely on the other half during recovery. Phalloplasty is a very intense set of surgeries, phallus creation is typically the most intense recovery wise because of the harvesting of the donor material. You want your body to put all its energy into healing one area at a time. Plus phalloplasty is a very long surgery, RFF can take like 8+ hours. It’s a lot to do at once, literally for the doctors and for a patient to recover from. But doctors such as Miroslav have done top and bottom together. The appeal would be get it all done at once, less times going under the knife.

Q: Can they use my chest tissue from top surgery?

A: No. Primarily because it doesn’t have the blood supply needed with a free flap, nor the nerves. I can’t imagine breast tissue would be good for a penis, especially because of the risk of breast cancer.

Q: Am I a good candidate for x type of phalloplasty?

A: People on the internet can give you an answer based on their best guess and informed opinion, but it’s impossible for us to tell as we’re looking at a picture or video and not your actual arm/leg/whatever. And we’re not doctors. Plus different doctors have different limits. (I see this asked on Reddit a lot. The answer is always “ask a surgeon”).

Q: Will my scars effect my candidacy for x type of phalloplasty?

A: Most likely no. Some people have self harm scars on their arms but if they’re not super raised or deep enough to cause nerve damage (the latter being rare) chances are you can still get RFF. However, tummy tuck or C-section type scars have a possibility to make you ineligible for abdominal phalloplasty.

Q: What happens to my tattoos on my donor site?

A: They’ll get relocated on your new member. It’s pretty awesome. Some people undergo laser tattoo removal prior to phalloplasty, some just keep them.

Q: Can they use clitoral tissue for the glans?

A: No. Not only is there not enough surface area, but there’s no way to stretch the Tdick that far, plus severing it to move it would serve no purpose. Sensation usually comes from nerve hookup.

Q: Can they use my natal erectile tissue so it can get hard?

A: No. The T dick has some erectile tissue, but not nearly enough to support the weight of a phalloplasty penis. If unassisted erections are important to you, maybe consider getting metoidioplasty.

Q: Why can’t they use the vagina to make the penis? Like the opposite of penile inversion for trans women.

A: For starters, the vagina is a stretchy hole, it doesn’t really have a structure. Imagine trying to turn your mouth or belly button inside out. The canal itself doesn’t have enough nerves, blood supply, or surface area to create a penis. Plus wet mucosal tissue isn’t made to be on the outside of the body. Not to mention trans people on T can get v atrophy.

Q: Why can’t they make the whole urethra out of buccal (mouth) tissue?

A: Buccal skin is the perfect skin type for urethras, it’s used to a moist environment. Which is why it’s saved for urethral repairs and not the entire urethra. You need more skin to create a whole neourethra, and your mouth is only so big.

And lastly

Q: Can I see?

A: NO. Never ask someone this. Your curiosity does not trump their comfort. If they want to show you, they’ll offer. If you’re so curious, you can Google it. There are plenty of places online to find pictures.