A transgender man could receive a penis transplant in a world-first surgery (Envato Elements)
Doctors in Boston are considering giving a transgender man a penis transplant in a move that could prove a “quantum leap” for gender-affirming surgery.
Only a handful of penis transplants have been performed in the past, and all of those were done on cisgender men who lost their genitals due to war trauma or cancer.
But now, doctors are keen to determine if the procedure could also be performed on transgender men.
“This would be a quantum leap if you were able to transplant a real penile structure,” plastic and reconstructive surgeon Curtis Cetrulo, who works at Massachusetts General Hospital (MGH), told MedPage Today.
“It’s certainly pushing the boundaries. We’re ready to do it, and we could do it pretty soon if we get it approved. I’m hopeful we can do it.”
Cetrulo added: “It would be super-helpful to a lot of these [transgender] patients.”
Penis transplant may be possible for trans patients, but there are roadblocks and uncertainties.
But there are roadblocks. There are no accepted guidelines for performing penis transplants because the procedure has been performed so rarely, and – because a trans man has never received a transplant – it is unknown if the transplant would prove effective.
Cetrulo’s hospital currently performs penis transplants in rare circumstances for cisgender men – but they are now considering extending protocols to trans patients, too.
If such transplants were possible, it could be “huge” for trans people, according to California-based gender confirmation surgeon Marci Bowers.
“This is like a heart transplant to someone who has end-stage heart disease,” Bowers said.
“It’s that big. Prior methods were just so substandard in so many ways.”
Currently, trans men who opt for bottom surgery can have phalloplasties – where a phallus is constructed from flaps of skin – or metoidioplasties, where a neophallus is built from clitoral tissue.
We’re ready to do it, and we could do it pretty soon if we get it approved. I’m hopeful we can do it.
Cetrulo believes that, if a full penis transplant was possible for trans patients, it would offer “fewer urethral complications, better cosmetic outcome, and better physiological sexual capacity”.
However, doctors also do not fully understand how the penis transplant would work. It is not yet known if a trans man who received a penis transplant could have an erection, while it is believed they would not be able to ejaculate due to the lack of a male reproductive system.
If a trans man received a penis transplant, he would also need to have his urethra lengthened, and doctors could encounter challenges in connecting nerves and blood vessels.
But the biggest challenge could be in finding donors – there are concerns that cisgender men and their families might object to donating their penises, while some fear that anti-trans bias could discourage others from donating.
If the surgery goes ahead, and is successful, it would mark a major shift in gender affirming surgery for trans men.