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A Guide to SRS

The surgery

Genitals are biological homologues of one another. This means the penis and vulva are derived from the same initial parts. What SRS aims to do is rearrange what you have into that alternate format.

This is an intense surgery. Drawn reference images are shown at the bottom of the page (figures 1-4) to give you a general idea of what the surgery entails structurally (this varies between surgeons). If you are squeamish do not look online for real life examples of the surgical procedure. The pictures and videos are very full on and I regret it.

Depending on the surgery you’ve chosen the process will look different.


Vulvoplasty (A.K.A Labiaplasty, minimal depth, zero-depth)

  1. Vulva is created (Labia, clitoral hood, clitoris, urethral opening.)

Penile Inversion Vaginoplasty (PIV)

  1. Vulva is created
  2. Vagina is created

Peritoneal Pull Through Vaginoplasty (PPV)

  1. Vulva is created
  2. Vagina is created
  3. Peritoneal flaps from your abdomen are integrated into the deeper section of vagina

Revision Peritoneal Vaginoplasty

  • Peritoneal flaps are integrated into the deeper section of vagina previously created. To my knowledge this is done either to add the lubricating capacity of the peritoneal lining after prior PIV. Or, to resolve complications impacting the vagina.

https://www.mtfsurgery.net/ A website with some additional information

My surgical experience

  • After getting to the hospital and handing in some paperwork, you wait around until it’s your time to get ready for surgery. After putting on the gown, a talk with a nurse, and some more waiting, you get wheeled in.
  • You meet a few people, talk to the anaesthesiologist, and Dr Hart briefly. You get two lines put into your inner forearms and one in the back of your hand. You are moved onto the operating table where you sit up, hold a pillow tightly to your chest while you’re held very still by another person, and then you’re then given an epidural. Your legs go tingly then numb. You lie down, they give you more IV drugs, fade to black.
  • You then wake up in the recovery ward (hours have passed but it will feel like only a second), you have whatever reaction you have to the anesthesia wearing off and then likely fall back to sleep. After the recovery nurses are happy with your state (and you’re a little more normal), you get wheeled into your hospital room.
  • I’m told my surgery took approximately six hours. Kieran says it typically takes four.












Vaginoplasty 1/4 Vaginoplasty 2/4 Vaginoplasty 3/4 Vaginoplasty 4/4 Images taken from this website: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/vaginoplasty-for-gender-affirmation