Phalloplasty is a type of surgery that takes existing skin, tissue, and nerves from surrounding areas on a patient’s body to repair or form a neophallus, or a new penis structure. In 1946, Harold Gillies, a plastic surgeon who practiced in England, performed one of the first modern phalloplasties that entailed creating an entire neophallus for a transsexual, called transgender as of 2022, man in London, England. The reconstructive need for phalloplasties started as a result of treating blast wounds during World War I and World War II. The techniques from that time allowed Gillies to perform a phalloplasty with urethral lengthening. Lengthening the urethra allows the patient to use the neophallus to urinate, for a transgender person as a means of affirming their gender identity. Phalloplasty procedures improve the quality of life for people who have congenital conditions, physical trauma, or are seeking gender affirmation surgery.

Harold Delf Gillies performed one of the first sexual reassignment surgeries, termed gender affirmation surgeries as of 2022, on record in 1946 in London, England. He also practiced modern plastic surgery and helped distinguish it as a new branch of medicine in London, England, starting in the early 1900s. Gillies’s work focused initially on facial reconstructive surgery, particularly during both World War I and World War II. Gillies created newer and more efficient techniques that later became standard procedures for reconstructive and cosmetic surgeries. Gillies, along with two members in his practice, standardized over 11,000 techniques, and beginning in 1946, he performed one of the first successful phalloplasties on a transgender man, where he formed a new penis from the patient’s existing skin and tissue.

Metoidioplasty is a type of gender-affirming surgery that creates a small-sized neophallus, or new penis, from an enlarged clitoris. Gender-affirmation surgeries are procedures that alter a person’s body, typically sexual characteristics like the genitals, to align a person’s sex with their gender identity so that they can move through society more comfortably. Such procedures treat gender dysphoria, which is the distress or discomfort that may be felt by transgender people. Transgender people’s gender identities differ from the genders they were assigned at birth, usually conflated with the sex they were assigned at birth. As opposed to a phalloplasty, a procedure where a neophallus is created using tissue from other areas of the body and not just the existing genital tissues, metoidioplasty allows transgender individuals to have a penis with less noticeable scarring, preservation of erogenous sensation, and, if the patient desires, the ability to urinate while standing. The technique was first suggested in 1973, then performed in 1974, however, doctors and researchers did not refer to it as metoidioplasty until 1989. Since its implementation, several modifications have ensured lower risks and better results for patients. Metoidioplasty improves the quality of life for people seeking gender-affirmation surgery by treating gender dysphoria.