Phalloplasty is one of the most complex genital affirmation surgeries within masculine transition processes. Its goal is not only to construct a functional neophallus but also to help trans people live with greater well-being, bodily coherence, and safety. However, there are still doubts, false beliefs, and unrealistic expectations surrounding this surgery. At IM GENDER, we want to offer a medical, rigorous, and approachable perspective on what phalloplasty can truly offer, and what aspects are important to understand before making a decision. For this reason, we present this guide on myths and truths about phalloplasty.
Myth 1: “I will always be able to urinate standing without any issues.”
Urinating while standing is one of the main goals for people undergoing phalloplasty, but achieving this safely requires time and planning. Urethral complications, such as fistulas or strictures, are among the most common causes for reintervention after this type of surgery.
To minimize these risks, at IM GENDER urethroplasty is performed in two surgical stages, an innovation that has been shown to significantly reduce these complications.
In the first stage, the neophallus is constructed without connecting the urethra, allowing the tissues to heal properly. Months later, during a second surgery, the definitive connection is made usually at the same time as placing the testicular implants.
This approach allows the urethra to be better vascularized and less exposed to the acidity of urine, reducing risks of strictures and fistulas and facilitating a safer, more comfortable recovery.
Myth 2: “I’m going to have a penis identical to that of a cis man.”
Phalloplasty can offer very natural looking aesthetic results.
In fact, Dr. Labanca, surgeon at IM GENDER, notes that some trans men who have undergone phalloplasty have attended check-ups with urologists who, at first glance, did not realize it was a neophallus. Aesthetic treatments can also be performed after phalloplasty to enhance the appearance of the neophallus.
Even so, anatomical differences exist: the tissue used comes from another part of the body (forearm or thigh), the texture is different, and erection depends on a prosthesis.
The goal of phalloplasty is not to replicate the exact anatomy of a cis penis, but to achieve a functional, harmonious, and aesthetically satisfying result.
Myth 3: “It’s a surgery with poor results and most people regret it.”
Nothing could be further from the truth. Although it is a complex surgery with potential complications, studies and clinical experience show high satisfaction levels. Most trans men report that, despite undergoing check-ups or lengthy processes, they would choose to have the surgery again without hesitation.
Beyond the aesthetic result, which is very good, the main benefit is the improvement in emotional well being, self-esteem, and the sense of fulfillment that comes from feeling more aligned with their identity. However, it is important to emphasize that not all trans men want phalloplasty or any surgery; each transition is unique and personal.
Myth 4: “If I have complications, the surgery has failed.”
Complications are part of the reconstructive process and should not be interpreted as failure. A fistula, a visible scar, or the need for a minor revision are common occurrences even in highly specialized centers such as IM GENDER.
True success lies in having an experienced team capable of addressing complications and supporting the patient throughout the process. Genital affirmation surgery is a journey, not a one-time event. Being well informed and clearing all your doubts before undergoing phalloplasty is essential.
Myth 5: “It’s just one surgery and then everything is done.”
Phalloplasty is usually carried out in several stages: creation of the neophallus, urethral lengthening, scrotoplasty, testicular implants, and later on, the possible placement of a penile prosthesis. Each stage requires its own recovery time, check-ups, and care.
For this reason, rather than thinking of a “single operation,” it is more realistic to understand it as a staged surgical process that culminates in a complete result.
Myth 6: “I will lose all erogenous sensation.”
Erogenous sensation is not lost because the clitoris is preserved and strategically repositioned during surgery, maintaining its nerve endings.
The way pleasure is experienced changes, but having fulfilling sexual experiences after phalloplasty is possible.
Over time, the brain integrates the neophallus as part of the body, and a new tactile sensitivity develops, which can expand sexual experiences. Each patient needs their own time for adaptation, support, and self-exploration to reconnect with pleasure.
Myth 7: “Without a penile prosthesis, I won’t have a satisfying sexual life.”
Not everyone wants or needs an internal prosthesis to have a fulfilling sexual life.
There are high quality external prostheses that allow penetration and offer good functional and aesthetic results.
An internal penile prosthesis can provide a firmer erection, but each case must be evaluated individually. There are also other options for achieving erection after phalloplasty. The decision should be based on personal desires, expectations, and lifestyle.
Myth 8: “Phalloplasty is always better than metoidioplasty.”
There is no universally “better” technique. Metoidioplasty and phalloplasty are two different paths toward the same goal: bodily affirmation.
Metoidioplasty preserves the clitoris’s spontaneous erection, offers a shorter recovery, and typically involves fewer urethral complications. Phalloplasty allows for greater length, standing urination, and, if desired, penetration with a prosthesis.
Each technique responds to different needs and priorities, and at IM GENDER we help each patient evaluate which option best aligns with their expectations.
Myth 9: “Phalloplasty is essential to be ‘truly’ a man.”
Gender identity does not depend on anatomy. Some trans men choose hormones and/or surgery, while others do not need them to feel complete. Both choices are equally valid.
Masculinity is built through lived experience, expression, and authenticity. Phalloplasty can be a powerful tool, but it does not define a person’s validity or identity.
Myth 10: “Hormone therapy is essential to achieve good results.”
Hormone treatment in trans men can influence skin texture, muscle mass, or healing, but it is not an absolute requirement for good surgical outcomes.
At IM GENDER, we evaluate each case individually, considering life circumstances, medical conditions, and each patient’s needs. What matters is that the decision to undergo hormone therapy, just like the decision to undergo surgery is free, informed, and supported.
Addressing Questions About Phalloplasty
Phalloplasty is a surgery that transforms bodies but also emotions and lives.
Each person experiences their journey in a unique way, with different timing, motivations, and goals.
At IM GENDER, we believe in honest information, comprehensive support, and absolute respect for each personal story. Our commitment is to offer safer, more human surgeries tailored to the real needs of trans people.
If you are considering a genital affirmation surgery such as phalloplasty, we can support you with personalized information and an integrated approach at every stage.
