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.

In the United States, most people are assigned both a biological sex and gender at birth based on their chromosomes and reproductive organs. However, there is an important distinction between biological sex and gender. Biological sex, such as male or female, commonly refers to physical characteristics. Gender refers to the socially constructed roles, behaviors, and actions people take on, usually in relation to expectations of masculinity or femininity. As of 2022, there is disagreement over the relation between sex and gender. People’s biological sex and gender greatly influence the way they understand themselves, as well as how others treat them and how they interact with society. Moreover, some people’s gender differs from what they were assigned at birth, and they face discrimination, harassment, and violence. Evolving understandings of gender and sex in the US have created more ways for people to live and express their gender identities.

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.

Christine Jorgensen was a transgender woman and activist in the United States who lived during the twentieth century. She was one of the first US citizens to publicly disclose her gender transition from male to female through gender-affirming surgery and hormone replacement therapy. By 1949, when Jorgensen began her transition, few individuals had undergone gender transition. Various popular media outlets reported on Jorgensen’s gender transition and surgery, which allowed Jorgensen to educate the American public on topics such as gender identity and sexual orientation. Jorgensen authored an autobiography in 1967, which detailed the journey of her life from early childhood to the end of her forties. Although many transgender people continue to fight for acceptance and equality in the US as of 2024, Jorgensen’s advocacy and activism increased transgender awareness for the general public at a time when existing and living openly as a transgender person received little recognition and support.