With the advancement of technology came the faster and wider spread of information. With that came the better understanding of transgender people and a change in the public’s perception about transgender people. Information for transgender people themselves about “who they are” and the availability of options about what to do have also been readily available due to the advancement of information.Transgender is a sexual concept that should be distinguished from homosexuality, a person who thinks of sexuality as opposed to the natural body. “Transgender” is an umbrella term that describes people whose gender identity or expression does not match the sex they were assigned at birth. For example, a transgender person may identify as a woman despite having been born with male genitalia. Because of cultural or religious factors, a lot of transgender people are forced to live their lives depending on their gender they were assigned with at birth and that creates a lot of confusion, stress, and even trauma for a lot of transgender people. Because of this, transsexualism is a concept that is should not be determined in one day norshould it never be.
Thailand is famous all over the world as a destination for transgender people because they are generally accepted here and not ridiculed.Patients from all over the world visit Yanhee International Hospital in Thailand for sexual reassignment surgery through adequate preparation and consultation, and live satisfying and fulfilling lives after surgery. Because of that, hospitals and doctors in Thailand lead the worldin terms of experience and value for money for services and procedures that cater to the needs of the transgender community such as sex reassignment surgery.

Sex reassignment surgery is a technique that requires high skill and is one of the toughest surgeries to perform even for experienced surgeons.This is the most advanced surgery in the plastic surgery category and must be done perfectly because any minor mistake can result to fatal side effects to the patient.Also, sex reassignment surgery is an irreversible surgery meaning once the surgery is done there is no going back if ever you change your mind.Many factors must be considered and confirmed before the surgery is performed, such as sufficient consultation with a psychiatrist, administration of hormones through a specialist, and sufficient time in living life of the opposite sex.

FTM (Female To Male Transgender) – Female to Male sex reassignment surgery is much more complicated and takes much more time to finish the whole process than Male to Female surgery.The procedures are divided till the complete penile reconstruction, which requiresvarious surgeries.Thereare preparations that must be done before the surgery. These are the minimum preparations required and must be followed.

  • You must be over 20 years old. You must also have experienced at least one year of life living as the opposite sex.

  • The duration of male hormone treatment must be at least 1 year. Male hormone therapy will make the patient look more masculine by increasing the development of muscles, increasing body hair, and a change in tone of the voice. It is appropriate to have surgery within 2 years of male hormone treatment because opposing hormones can cause various side effects in the body andmay cause cancer. You need a letter of referral from your doctor about the state of your male hormone treatment that states how long you have been having the treatment (at least 1 year) and you will need to stop taking it at least two to four weeks before the surgery.

  • A psychiatrist’s letter of referral from your country that confirms you are eligible and stable enough to undergo the surgery is needed and must be in English. Indeed, it’s the psychiatrists, not the plastic surgeon that determines if you are eligible to undergo the sex reassignment surgery. In addition to the letter issued from your country, you have toalso undergo a consultation with the psychiatrist of Yanhee InternationalHospital to ensure the prudence of the surgical decision.

  • Drinking and smokingcan result to adverse effects to the outcome of the surgery. We recommend quitting drinking and smoking at least two weeks before step 1 surgery. Due to long procedure and many other surgeries required after step 1 we advise the patient to quit themabsolutely for step 2 and step 3. Should the patient choose to continue to smoke and drink alcohol, the patient should quit for at least 3 months before step 2 and until after step 3. If your doctor becomes aware the you smoked between step2 and step 3, the doctor will cancel step 3 procedure until you stop smoking.

  • You must be in good health to undergo the surgery not only for the surgery itself but for the long-term hospital stay and post-operative care.

Processes before the surgery

  • Meet with the doctor who will perform the surgery. At this point, your doctor will check your psychiatric findings and your health status.If there are no reasons for disqualification, the doctor will determine the site of surgery and explain to youthe procedure.

  • After signing the various consent forms, payment is completed and various tests prior to surgery are performed.

  • After anesthesia and psychiatric consultations, return to your room and relax.

  • You will be staying in the patient’s room to prepare for the surgery. An enema will also be done while you are in your room.

Surgery steps and methods

The step 1procedure (breast removal and uterine and ovarian extraction) is usually performed together to reduce the burden on the body, such as anesthesia for multiple surgeries. The complete partnership of Yanhee sex assignment surgery team through the years are helped produce better results and patient satisfaction.

  • Mastectomy – This is the most satisfying surgery for FTM patients. If there is less tissue at the breast, surgery will be done with the incision that is almost invisible through the areolas. But if the breast is big, inverted T scar or inframammary scar will be made to remove the breast tissues. Because of the complex structure of nerves and blood vessels at the breast, a high level of skill is needed to extract only the tissues of the breast. Steady exercise and care after surgery will help you create a more perfect masculine chest line.

  • Uterus and Ovarian Extraction – The uterus and ovaries will be removed from your body, which are the largest female organs that produce female hormones. In the case of abdominal incision, about 7cm of the incision will be made at the lower abdomen.When the pubic hair around the epilated genitalia grows, the suture line won’t be visible.A laparoscopic method with an incision of less than 1 cm has the advantage of fewer scars and faster recovery.

The step 2 surgery (vaginal closure, urethral lengthening and urethral prefabrication) is also usually done together and is a very important step in preparing for neophallus reconstruction at next step.

  • Vaginal closure and Urethral lengthening – Since women’s urethra is much shorter and lower than men’s, there are many inconvenient factors if the neophallus constructed without the precedence of urinary track modification as the urethra locates low so the neophallus locates between two legs and also has high risk of leakage of urine from improper joining of urethral which is difficult to correct.We received a lot of inquiries about the above problems which has done in other hospital and have consulted with many doctors in field since the business started, so we can confidently explain you about the risks, how important it is and understanding of FTM surgery. The urethra is adjusted to the highest possible position according to the patient’s original physical condition (location of the pubic bone), and then the neophallus will be positioned at that location at the step 3 surgery.For the vagina, it is partly used to extend the urethra, the rest is removed completely, so that there is no space left, and the entrance to the vagina will be closed.

Total Phalloplasty (RFFF) – This is the final stage of genital reconstruction, the final stage of FTM transgender surgery. After the step 2 surgery, at least six months after the urethra at the forearm has been properly managed, the neophallus will finally built to resemble the male genitalia in appearance. The tissues, such as the urethra, skin, and nerves of the forearm, which have been built in advance, are removed, and then finely bonded to form of penis, and the scrotal sags are formed from the original labia. It looks similar to the male genitals in appearance, and the neophallus are usually made of 5-6 inches long and around 5 inches in circumference. To minimize various side effects, support neophallus and secure the space of urethra, the specialized penile implant will be inserted at the same time.

  • Urethral prefabrication – At the step 3 surgery, the skin and nerves and other tissues are implanted from the forearm to rebuild the neophallus. At the step 2 surgery, the inner skin along the hip line will be cut to build the urethra inside the forearm, which is then used to prevent narrowing of the urethra, one of the major side effects of neophallus reconstruction. It is very detailed and cautious processes with a very special technique using microscopic endoscope so that the post-operative care is required as much as surgery.



  • After surgery, the patient is prohibited from eating meals containing water for about two days as instructed by the gynecologist.

  • Mayhave some abdominal pain after a painfree system over because of incision at abdomen.

  • Doctor will visit the patient every day to see if there is abnormalities on surgical area and do the dressing if necessary.

  • After staying in hospital for 6 nights, stay at the hotel for about 5 days and come to hospital to have follow checkup for any abnormalities and remove the suture. You can flight back to your home after that.


  • There is no restriction on food after surgery, but need to stay on the bed only for 6 days during your 7-night hospital stay.

  • Surgical area can be affected by inserted foley catheter so excessive movement should be refrained.

  • Doctor will visit the patient every day to see if there is abnormalities on surgical area and do the dressing if necessary.

  • After staying in hospital for 8 nights, stay at the hotel for about 5 days and come to hospital to have follow checkup for any abnormalities and remove the suture and stapler. You will learn how to dressing the wound, which is most important things to know. You can flight back to your home after that.


  • Patient will be admitted two days before surgery.

  • Air cushioned bed is prepared for long time stay on the bed.

  • There is no restriction on food after surgery, but you should keep in the same position for long time. You need to get enough nutrients and drink plenty of water to drain urine smoothly.

  • There are restrictions on movement so you should not force yourself to move.

  • Doctor will visit the patient every day to see if there is abnormalities on surgical area and do the dressing if necessary.

  • During the 14 nights in the hospital, you must stay at least 10 days on the bed only after your surgery, doctor will remove the foley catheter then you can start walk.

  • Urinate in standing by yourself and nurse will check all the time then will teach you how to use a catheter. You should be aware of this as it is a task that needs to do every time you go to toilet.

  • After staying in the hospital for 14 nights, stay at the hotel for about 10 days and come to hospital to have follow checkup for any abnormalities and remove the suture. You can flight back to your home after that.

Post-operative care


  • Avoid intensive movement on the abdomen for about a month.

  • Must wear the breast compressions garment for about a month.

  • After about a month, you can start light exercise.


  • You should dressing the forearm at least twice a day from the day instructed. Keep it clean and be diligent as directed until the step 3 surgery.

  • Dressing the wound at genital every time after toilet for about a month as directed.

  • Take a good care of forearm for about 2 months that the wound strongly healed, and please contact us immediately if any abnormalities noticed.

  • The forearm dressing should be done at least twice a day until the step 3 surgery, and send us a picture of the progress as you need or upon our request.

  • Once your arm is healed, you can start exercise within a reasonable range. However, avoid intense exercise or work that could hurt your arm.

  • Sometimes stitches can be found at the forearm or genital area. Please do not mind as it’s a melting thread. If necessary, carefully cut it with clean sterilized scissors without pulling out them.


  • Every time after toilet use, clean the catheter as directed and reinsert it immediately.

  • For about two months, consider those period as you recover your energy and strength and refrain from activities and focus on recover your health by enough resting and eating good food.

  • The catheter must be used all the time for first three months and night time only for another three months. You may not use the catheter after total of 6 months of care, but if you are uncomfortable with urinating afterwards, use the catheter occasionally.

  • Use of the catheter is a minimum measure to prevent further problems after neophallus reconstructed. So fulfill the instructions as directed.

  • Numbness of forearm will improve after about 2 months. In addition, the neophallus is initially insensitive but after about six months, the sensation will begin to be noticed slowly.

  • After shower, apply baby lotion or oil on the forearm and hips to prevent dry skin.

Important notes

  • You may think that self-care after surgery is cumbersome and difficult. However, it is fact that the risk of side effects from FTM surgery is higher and more frequent than any other surgery. That’s why doctor’sexperiences and skills are so important, and your self-care should go beyond that. To have FTM transgender surgery should be careful and selective because it is also very difficult to make corrections if there is problem.And trusting the doctor you choose to follow will minimize problems, and even if there is a problem, there can be chances for resolution. Dr. Sukit,worldwidely known FTM Transgendersurgeon at Yanhee International Hospital, and our specialized doctors in charge for FTM transgender surgery are always take upon themselves with their great responsibilities and sense of duty over their world-class fame, demands the patients to control themselves strictly.

  • Things to prepare before surgery are required and minimal matters.

  • You must stop drinking and smoking. During surgery, blood vessels constrict, causing relatively high blood pressure, which causes a lot of bleeding. This will affect the outcome of the surgery. Especially FTM surgery, microvascular bonding is very important in operation, so absolutely no smoking is required.

  • The staff in the hospital are experts who have already experienced a lot of patients. Please kindly follow the instructions.

  • Self-care is as important as the importance of surgery. Neglecting to be cumbersome and difficult to manage can cause side effects and problems later, so be sure to follow the instructions carefully and keep it in order.

  • Please let us know whenever you find any abnormalities or questions.


  • Mastectomy (Areola incision): 2 nights – 111000 THB

  • Mastectomy (Inverted T scar or Inframammary scar): 2 nights –  131000 THB

  • Body weight over 70kg: add 25500 THB 

  • Uterus and Ovarian Extraction (with abdomen incision ): 4 nights – 96000 THB

  • Uterus and Ovarian Extraction (with laparoscopic): 2 nights – 131000 HB                                                 

  • Vaginal closure and Urethral lengthening: 7 nights (preceded with abdomen incision at step 1) 181000 THB

  • Vaginal closure and Urethral lengthening: 7 nights (preceded with laparoscopic at step 1) 201000 THB

  • Urethral prefabrication: 1 night – 85000 THB

  • Total phalloplasty (RFFF): 14 nights– 371000 THB

  • Areola reduction: 50500 THB

  • Nipple reduction: 40500 THB

  • Lipofilling at breast, penile or scrotal,etc: 50500 THB per site

  • Coronoplasty: 2 nights – 96000 THB 

  • Other surgeries: Please inquire us