This page is general information. Whether any procedure is suitable for you can only be decided after an individual clinical assessment by a qualified surgeon, and requirements differ between providers.
- Anaesthesia
- General
- Stages
- Usually 2–3 operations over a year or more
- First-stage hospital stay
- Commonly 1–2 weeks
- Time in Thailand (first stage)
- Commonly 3–4 weeks
- Donor site
- Forearm or thigh, leaving a visible scar
- Implants
- Erectile and testicular implants, if chosen, come last
What phalloplasty involves
Phalloplasty builds a penis from donor tissue. Depending on goals, the plan may include urethral lengthening (to urinate standing), scrotoplasty, removal of the vagina (vaginectomy), glansplasty (shaping the tip) and, later, erectile and testicular implants. Many people have had a hysterectomy beforehand or at an early stage. Some choose phalloplasty without urethral lengthening to reduce complications.
Donor sites
- Radial forearm free flap (RFF): the most common; thin, sensate tissue, leaving a visible forearm scar that is covered with a skin graft.
- Anterolateral thigh (ALT) flap: avoids a forearm scar; often thicker tissue, and sensation may be less.
Permanent hair removal on the donor site is often needed before surgery if the urethra will be built from it.
Requirements
Surgeons generally follow WPATH SOC-8: a documented assessment, capacity to consent, well-managed health and, unless not appropriate or not desired, a period of hormone therapy. Not smoking is essential for flap survival. Ask each surgeon exactly what they require.
Recovery
- First stage in hospital: close monitoring of the flap, bed rest, catheter and drains.
- Weeks 2–4 in Thailand: wound and donor-site care, follow-up and catheter management.
- Months: later stages are usually spaced several months apart; plan for more than one trip.
- Full recovery and the final result take a year or more.
Risks
Phalloplasty is complex and complications are relatively common. The most frequent involve the urethra: fistulas (leaks) and strictures (narrowing) that may need further surgery. Other risks include partial or complete flap loss, donor-site problems, infection, bleeding, blood clots, reduced sensation and implant problems. Ask surgeons for their own complication and revision data.
Planning travel
Plan around 3–4 weeks for the first stage and shorter stays for later stages. Confirm how complications are handled if they appear after you return home, and ask for detailed operation notes in English.
What affects the cost
The number of stages, donor site, urethral lengthening, hospital nights and implants all affect the total. Ask for a written quote for each stage and for managing complications. See our cost guide.
Choosing a surgeon
Confirm the surgeon's licence with the Medical Council of Thailand and relevant specialist training, ask how many phalloplasty procedures they perform each year, and how complications are handled after you return home. See our checklist.
Surgeons and hospitals for phalloplasty
Verified surgeons profiles are being added
We list surgeons only after checking their licence, training and hospital affiliations against official sources for phalloplasty. You can still book now: our patient team matches you with a suitable provider and confirms the booking.
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Frequently asked questions
How many surgeries does phalloplasty take?
Usually two or three stages over a year or more, depending on the plan and whether implants are included.
How long do I need to stay in Thailand?
Commonly three to four weeks for the first stage, with shorter stays for later stages.
Can I urinate standing after phalloplasty?
If urethral lengthening is included and heals well, many people can. Urethral complications are the most common problem and may need further surgery.
Forearm or thigh flap: which is better?
The forearm flap is thinner and usually has better sensation but leaves a visible forearm scar; the thigh flap avoids that scar but is often thicker. Your surgeon advises based on your body and goals.
What is the difference between phalloplasty and metoidioplasty?
Metoidioplasty uses the hormonally enlarged clitoris to create a smaller phallus in fewer stages; phalloplasty builds a larger phallus from donor tissue.
Sources
- Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. WPATH / International Journal of Transgender Health (2022). Accessed 2026-09-23.
- Guidelines for the primary and gender-affirming care of transgender and gender nonbinary people. UCSF Transgender Care. Accessed 2026-09-23.
- Medical Council of Thailand. Medical Council of Thailand. Accessed 2026-09-23.
This page is written by our editorial team from the sources above. Independent review by a licensed surgeon is being arranged; until then it is marked as review pending. See our medical review policy.