Metoidioplasty in Los Angeles
Clitoral release after testosterone, with optional urethral lengthening and scrotoplasty. A different operation from phalloplasty, not a smaller version of it.
Using what testosterone has already grown
Metoidioplasty releases the hormonally enlarged clitoris from its ligamentous attachments so more of it stands away from the body. Optional steps include urethral lengthening (so standing urination is possible) and scrotoplasty with implants. It uses local tissue. There is no forearm or thigh flap, no donor-site scar of that kind, and typically a shorter staging calendar than phalloplasty.
Length is limited by what testosterone has produced. We will measure and tell you the truth in consult, including whether your goals (penetration, standing urination, a larger phallus) point to meta, phallo, or a sequence. Hysterectomy may already be done or planned; we coordinate rather than assume. See gender-affirming hysterectomy.
Dr. Maurice Garcia is the genital reconstructive surgeon for this work. Hair removal, letters, and insurance pre-authorization run for months, not weeks. Medi-Cal, LA Care, IEHP, and private plans often cover metoidioplasty when medically necessary.
Building blocks
Simple metoidioplasty (release)
Ligament release and repositioning without urethral lengthening. Shorter surgery, fewer urine-related complications.
Urethral lengthening
Extending the urethra through the phallus for standing urination. Higher risk of fistula or stricture; we discuss that plainly.
Scrotoplasty and implants
Creating a scrotum from labial tissue and placing testicular implants, often staged.
Vaginectomy
When urethral lengthening is planned, closing the vaginal canal is often part of the same reconstructive logic.
What to expect.
Hormone and anatomy exam
How much growth you have, what you want the phallus to do, and whether phalloplasty would serve those goals better.
Staging map
Hysterectomy, hair removal, meta, implants. Each date has a recovery that cannot be wished shorter.
Surgery and catheter time
If the urethra is lengthened, catheter care is part of the job. We teach it before you leave.
Follow-up
Urination, sensation, and whether a later implant stage is still what you want.
Frequently asked questions
How do I choose between metoidioplasty and phalloplasty?
Meta uses your own hormonally enlarged tissue and has no flap donor site. Phallo can create more length and girth with a flap, in more stages, with more scars. Neither is the default. Goals and anatomy decide.
Can I have phalloplasty later if I start with meta?
Sometimes, with constraints. Tissue already used is not unused. If phallo is a serious maybe, say so now so we do not spend structures you would need.
Does insurance cover metoidioplasty?
Often, as medically necessary bottom surgery. Urethral lengthening and implants may be authorized as part of the same episode or separately. We submit what the plan requires.
Compare metoidioplasty with your goals
Bring what you want the result to do, not only what you want it to look like.