Gender-Affirming Surgeries: Chest Construction, Phalloplasty, and More!


Gender-Affirming Surgeries: Chest Construction, Phalloplasty, and More!

Some people who are transgender, non-binary, or both have surgeries to feel more comfortable in their bodies. These are called gender-affirming surgeries. Some people want chest construction, phalloplasty, or other surgeries that we talk about here. Some trans and non-binary people also think about vaginoplasties, breast construction surgeries, or other surgeries.

Not all trans and non-binary people choose to have surgery. It’s a very personal decision. Lots of surgeries can help trans people be happier and more confident in their bodies. Every trans and non-binary person can choose to have or not have surgeries that work for them!

Top Surgeries or Chest Construction

This is when surgeons remove parts of someone’s chest and potentially reshape it. Surgeons might recommend certain surgeries depending on someone’s preference and the size of their chest. There are four common surgeries:

  • Keyhole: recommended for people with A cups. It leaves a small scar and they keep the sensation in the nipples.
  • Chest reduction: reduces the size of the chest but doesn’t create a masculine chest. Some people chose this option because a smaller chest feels right for them. It’s also a good option if they want to chest-feed.
  • Periareolar: recommended for people with B or C cups. It leaves scarring around the nipple/areola and they keep sensation in the nipples.
  • Double-incision or subtotal masectomy: recommended for people with C or D cups. It leaves bigger scars and might change the way your nipples look or feel. Surgeons might need to move some people’s nipples and reattach them somewhere else. This can make the sensation in them go away.

Even a subtotal mastectomy only takes 1.5-2 hours. You can go home the same day. It can take 4 weeks before you feel recovered and 6 weeks before you can do all of your usual things.

RAMQ covers top surgery. Without insurance it costs about 9,750$.

Bottom Surgeries


A phalloplasty is when surgeons do a few procedures to make a penis that has sensation. People can choose procedures that let them pee standing up, get erections, and penetrate partners with their penis.

The penis is partly made from someone’s internal privates. It also uses some skin from their arm, leg, or side. A scrotum is made from external privates, like the labia. If someone wants, a surgeon can do separate procedures to…

  • Add an implant that lets someone get erections and penetrate partners with their penis
  • Add testicular implants to make a fuller scrotum
  • Make the urethra longer to let people people pee standing up

The results of a phalloplasty are different for everyone. It’s a complicated procedure and you can choose what parts of it you want.

A phalloplasty can take about 6.5 hours and you have to stay in the hospital for 3 nights. It can take 6-8 weeks to recover and three months before you can do all of your usual things.

Phalloplasty is covered by RAMQ. Without insurance, it costs about $43,900.


A metoidioplasty will make a penis that is very sensitive and lets someone pee standing up. People can get erections after this surgery, but they won’t be able to penetrate someone with their penis.

This surgery makes a penis by cutting the ligaments around someone’s bottom growth. This releases it from the pubis, making a penis around 4-6cm long. If someone wants, surgeons can also…

  • Let someone pee standing up by lengthening the urethra and putting it in the penis
  • Make a scrotum from someone’s external privates
  • Add testicular implants to make a scrotum fuller
  • Make the penis wider with skin from external privates

It takes around 1-2 hours to have a metoidioplasty and you have to stay at the hospital for 2 nights. It would take around 3-4 weeks to recover and 6-8 weeks before you can do all of your usual things.

The surgery is covered by RAMQ. Without insurance, it costs about $25,000.

Reproductive Organ Surgery or Hysterectomy

This is when surgeons remove the uterus and other reproductive organs. They might remove the fallopian tubes, cervix, or ovaries. A surgeon removes different organs depending on someone’s body and what they want.

Surgeons can do a hysterectomy with a small camera and tools. This leaves a small scar. They can also make a large cut to do the operation. This leaves a bigger scar.

This surgery lets someone stop their monthly bleeding and lower their dose of testosterone. A lot of them can stop getting pap tests. Their risk of ovarian, uterine, and cervical cancer can go away. People also won’t be able to get pregnant after a hysterectomy.

A hysterectomy takes around 1 hour and you have to stay in the hospital for one night. It takes around 4 weeks to recover and 6 weeks before you can do all of your usual things.

Hysterectomies are covered by RAMQ. They cost about $6,000 without insurance.

Other Surgeries

There are lots of other surgeries you can get. Some people might want to have a broader face, a bigger chest or an adam’s apple. Sadly, RAMQ doesn’t cover these surgeries. It could also be hard to find some in Canada.

If you want any more surgeries, talking to a doctor might help. They can help you learn about services to help you feel more comfortable with your body.

More info

Trans Care BC – Surgeries

A government website explaining different gender-affirming surgeries. They also have workbooks for thinking about surgeries, recovery, and aftercare.

GRS Montreal

METRO HENRI-BOURASSA A Montreal clinic that specializes in gender confirmation surgery. They can help make gender-affirming private parts and appearances for transgender people. Services MTF…

Sante Trans Health (English)

A website giving resources for transgender people in Montreal and the people who are working with them. Includes information on transitioning, finding support, and transitioning…


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