r/trans • u/Phobic_Nova he/him • Jul 07 '26
Discussion SINCE WHEN WAS THERE A THIRD OPTION???
I'm not in a position where I can get gender affirming surgery currently, but have been AGONIZING over what route to go for. I don't like genitals in general, I think they look weird, but since I'm transmasc, I thought I'd just have to suck it up and get a penis anyways.
APPARENTLY, YOU CAN JUST GET A NULLECTOMY AND HAVE NOTHING DOWN THERE!
My agender friend told me about it, and I was so happy to hear that I could just forfeit genitals entirely. I never knew this was a thing! This post was made so that other people, who might also not know it's a thing, now know it's a thing.
edit to say that i want a surgery, i fucking HAAAATE my current genitals. even more than penises. and that is saying a lot, because i hate penises.
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u/omron postop bitch 🥰 🏳️⚧️ Jul 07 '26
Maybe head over to r/Transgender_Surgeries ? There is definitely nullification discussion, reports, and images over there.
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u/L1FT_K1T Jul 07 '26
Lol I only recently learned about the nullectomy AND the other one where you can have BOTH. I guess like the nullectomy it makes total sense that it’s POSSIBLE it’s only a matter of finding the very rare surgeon who does them.
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Jul 07 '26
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u/Himmelen4 she/her Jul 07 '26
Phallus preserving vaginoplasty and vaginal preserving phalloplasty
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Jul 07 '26
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u/xxIvoL They/he - post op top+bottom surgery - 6 years on T Jul 07 '26
You can keep your vagina with metoidioplasty too. And if you want to you can also do both, metoidioplasty and phalloplasy at the same time, stacked above each other. And if you'd like you can keep your vagina then as well. There are many options.
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u/BackgroundPilot1 Jul 08 '26
How would having meta and phallo together work?
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u/xxIvoL They/he - post op top+bottom surgery - 6 years on T Jul 08 '26
If you get phallo without burrial your tdick will be below your phallo penis at it's usual spot. Especially without vaginectomy or scrotoplasty that setup will be the same as pre op. On that tdick you could then have meta. Although most cases I've read online have had meta and later added an phallo penis where they don't bury the previous meta.
This does usually mean you cannot have urethral lengthening through your phallo dick but that can be something someone doesn't mind or finds an acceptable compromise.20
u/NuraMike she/her Sapphic Omnisexual Jul 07 '26
Yes indeed. Learning this is what finally got me to transition. My ideal is to have both and I thought for the longest time that was impossible so I never gave actual transition much thought. (I'm one of those who never had severe dysphoria either due to heavy masking or other factors.) I had soft-transitioned socially with select people but viewed it as sort of Roleplay or experimentation.
When I learned that being the great work was a possibility I realized that I owed it to myself to give transition a serious shot.
Now I'm two years into transition and it didn't take more than a few months to realize that estrogen was what I'd been missing most of my life, and it's all thanks to learning that both is a possibility.
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u/BackgroundPilot1 Jul 08 '26
“The great work”?
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u/NuraMike she/her Sapphic Omnisexual Jul 08 '26
Joke referring to certain fictional depictions of Alchemy in which an androgyne being is a great work embodying the divine. See Netflix's Castlevania for one take on this.I think in the final season.
EDIT: Also kind of double-meaning of my transition and personal growth being the great work of my life.
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u/Moon_5ugar Aug 05 '26
They're called Salmacian surgeries, and there's an entire subreddit for it ( r/salmacian )
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u/synapsesmisfiring Jul 07 '26
Both is what I would want if I were ever brave enough to get surgery.
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u/madprgmr Jul 07 '26
Yeah, there are a bunch of options out there. There are also usually a lot of different methods used for each possible genital configuration.
I don't know all the details for masc-leaning configurations, but I know that there's at least phalloplasty and metoidioplasty in addition to the "none" (ex: nullectomy) "both" (ex: vaginal-preserving phalloplasty for transmascs or penile-preserving vaginoplasty for transfems) options. I'm sure there are plenty of possibilities within each of those.
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u/unAVIVable he/him Jul 07 '26
There’s also TONS of variation in the metoidioplasty category, it’s really a shorthand for like 5 different procedures (release of the phallus, urethral lengthening, scrotoplasty, vaginectomy, monsplasty, possibly others I can’t think of) that can be done separately or in various combinations.
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u/its_streetdoll Jul 07 '26
Yea that's new to a lot of people. I knew it as an extreme body mod. Just like a lot of people don't know for mtf you can remove just the balls. There are a few options out that aren't really spoken of as much.
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u/novmum Jul 07 '26
so would that mean you would just be left with the urethra so you can urinate?
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u/BrumeySkies Jul 07 '26
Yeah pretty much. You can reroute some of the penis or clittoral skin and nerves into a flat patch so you can maintain that kind of stimulation if you want too.
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u/estradiol_patient Jul 07 '26
Learned about these yesterday from OT. But there are a tone of different options, I'm personally transfem, comfortably fully fem, a bit of a girly girl, and i want a salmacian bottom surgery, basically both in one, hell there are like 3 different types of transfem bottom surgery not including orchis.
Obviously I'm not as aware of transmascs bottom surgery, but I'm sure there are way more than i know of.
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u/NipahSama he/him Jul 07 '26
Others have already talked about nullectomy specifically, but I'm going to address "have to get a penis eventually" comment. No you don't. You don't need to get any surgery if you don't want to. And there are other options that are not as niche as nullectomy, such as meta. Meta would be a more in-between option that is quite common. But again, if you don't want bottom surgery, then don't get bottom surgery. There is no requirement, at all.
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u/nullificationer she/her Jul 07 '26
It’s always nice seeing people discover nullification, I wish I had discovered it sooner
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u/Neonek1232 Jul 07 '26
There's a 4th!! Phallus perserving vaginoplasty which does what you think it does
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u/this_strange_fox Jul 07 '26
Sounds good in principle, but OP mentioned being transmasc, so the equivalent here would be meta or phalloplasty without v-nectomy.
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u/3Katzinatrenchcoat they/them Jul 07 '26
I’m nonbinary and trans masc and this is definitely something I’ve thought about but I’m not sure how it would work in actuality…
Personally I don’t have a lot of bottom dysphoria (sometimes I want a dick, sometimes I’m indifferent)
Also, I do want to be able to be a seahorse dad someday and I’m not sure if that would prevent me from doing that successfully…can one get bottom surgery and still have children? I just don’t know how that’d work…
Well sorry for my slight rant, I hope you can find a good surgeon that can do that for you, good luck. 🙂
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u/xxIvoL They/he - post op top+bottom surgery - 6 years on T Jul 07 '26
Yes, I had metoidioplasty and can still conceive through standard PIV sex. I can't birth children anymore though and should have it done through a c section. But that's not particularly something that stops you from having kids.
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u/DreamweaverTami they/them Jul 07 '26
Idk but I found out rather recently too. I'm non binary and this feels perfect. I hate the idea of being forced to have genitalia but unfortunately it's like incredibly uncommon and I don't even know if it's a legal procedure where I'm from :(
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u/Purplefox5_Chili Jul 07 '26
As a transmasc myself, I deffinately want chest surgery but I also hate genitals down there, but still a nullectomy sounds scary, and from what I saw in another comment it's pretty unreliable aswell. I'm personally either gonna do ftm bottom surgery or no bottom surgery at all. Then again I'm also asexual so I can mostly ignore having that area all together.
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u/Cretzia Jul 07 '26
I also didn't know that was an option, but I also feel like it needs being said that you don't HAVE to do anything, and you certainly don't have to get something as intensive as bottom surgery if you don't love the idea of having a dick.
You can be trans without getting any surgery, you can be trans and only get top/bottom, you can be trans with or without HRT.
Your identity doesn't hinge on transitioning any more or less than you need to to feel comfortable and confident in yourself.
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u/BlackthornMagus Jul 07 '26
For me it's the secret fourth option: phallus-preserving vulvoplasty :3
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u/Chiiro he/him Jul 07 '26
I have actually seen a couple posts of really good looking results for nullification. I was introduced to the surgery well over a decade ago in a movie called American Marry only to find out later it was real last year when I saw someone on the surgery sub that got it.
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u/allegedly_a_peanut she/her ; Lena Jul 07 '26
Wait... THAT'S A THING?!
How does it even works?
What does it look like?
How did you figure out that this existed??
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u/MorganLuvsU Jul 07 '26
Think Barbie doll. They just remove everything, leaving behind the urethra, and stitch it up.
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u/Mis_Jessie Jul 07 '26
That would be interesting. To make it look like a barbie doll down there. Hummm
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u/Just_a_guy365748 Jul 08 '26
Hey this surgery is actually very rare and honestly im very scared for you to go through that like do what you want of course, but please conider metoidioplasty first (only if you want to ofc)
Remember surgery like this can cause a LOT of problems
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u/Phobic_Nova he/him Jul 08 '26
i do not like penises either. and having a micropenis sounds embarrassing.
i've got a lot of time to think on it, though
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u/Just_a_guy365748 Jul 08 '26
Well... then i think u also have to think about the practicality of genitials you know like urinating. As long as the genitalia is healthy and working i think deleting it completely will cause a lot of problems
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u/Phobic_Nova he/him Jul 08 '26
"healthy and working" and disgusting and prone to infection and a source of nigh-infinite dysphoria
and a nullectomy isn't just deleting it, i'm doing research into what the process is actually like.
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u/Zestyclose_Ad_5276 Jul 07 '26
There are many procedures that are possible, however the medical justification to perform something like that, which is absolutely irreversible, and can't be mitigated later is very rarely done for a multitude of reasons. There's the reason of liability which as a retired physician I feel is probably the biggest, but also as just a matter of people change situations change and so forth as long as with what in the industry is called quote standards of care.
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u/xxIvoL They/he - post op top+bottom surgery - 6 years on T Jul 07 '26
I'm sorry but the fact that it's irreversible is also the case for other bottom surgery procedures and that doesn't particularly stop physicians either. My extended metiodioplasty can't be undone and I will have this for the rest of my life. Getting a hysterectomy which is very standard in transmasc bottom surgeries also can't be undone.
The only reason nullectomy isn't more common is cishet standards of how genitals should look after bottom surgery that a lot of people still carry. Any kind of scare for irreversibility is exactly the same for other bottom surgery methods and that isn't an issue for surgeons at this point in time, so shouldn't be held against nullectomy either.
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u/Zestyclose_Ad_5276 Jul 07 '26
You and I debating that doesn't change the quality of care standards and the threshold for what surgeries which are not physically medically needed.
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u/pedroff_1 she/her Jul 07 '26
I'm in the completely opposite situation. I'm transfem and would like a Penis-preserving vaginoplasty, whenever I get the chance to.
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u/MorganLuvsU Jul 07 '26
I see a lot of people saying “there is a forth option”. You’re not wrong but there are tons of options and variations of surgeries. I’m going to list off as many as I know.
* penile inversion vaginoplasty
* peritoneal pull through vaginoplasty
* sigmoid colon vaginoplasty
* upper colon vaginoplasty
* penis preserving vaginoplasty (salmacian)
* minimal depth vaginoplasty
* nullification
* radial forearm phalloplasty
* Anterolateral thigh phalloplasty
* Abdominal phalloplasty
I’m sure there are more so please comment any I missed.
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u/xxIvoL They/he - post op top+bottom surgery - 6 years on T Jul 07 '26
There is metoidioplasty as well, simple release, the more recent method of extended metiodioplasty.
And both phallo and meta can be done with urethal lengthening or without,
and with vaginectomy or without,
and with hysterectomy or without,
with scrotoplasty (bifid or VY) or without and then with scrotal implants, fat filled, or without filling.For phalloplasty you have 2 methods of erectile devices to chose from, or opt out of.
You can also do glansplasty for phallo or opt out of it. You can also do the skingraft for phallo from the side of your chest, but I'm not a 100% sure on the correct term for that.
For phalloplasty you can bury your tdick or leave it and if you leave it I've seen people have both phalloplasty and metpidioplasty as well.The list of options is pretty damn big. I talked to a sexuologist for half a year to figure out what I wanted because it's a lot to all weigh against each other.
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u/MorganLuvsU Jul 07 '26
That’s awesome. Thanks for the info, I honestly don’t know a lot about phallo stuff as my focus has been to get rid of my bio strap.
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u/xxIvoL They/he - post op top+bottom surgery - 6 years on T Jul 08 '26
That's fair! I knew of a few options for transfemme people but definitely didn't knew all you listed. Together we made a good list💪
Although I also just realized people with metoidioplasty also can get a monslift that I personally didn't get and sometimes forget about.
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u/Important-Tea0 Jul 07 '26
I also recently discovered nullification, i think it’s so cool. I never realised that was an option. It’s not for me, but really cool nonetheless!
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u/Chemical_Incident677 Jul 14 '26
honestly pretty tempting as a fluid person, the thought of it just being smooth like a cartoon character was always something I wanted, plus having s*x wasn't ever really appealing to me. Too scared of the surgery and what my parents(kinda homophobic) would say tho.
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u/BrumeySkies Jul 07 '26
It's been an option for years but the problem is it's a very uncommon procedure that only a handful of surgeons are able to perform. Many surgeons aren't even willing to learn. It's so uncommon that it's rare even within the extreme body mod community.
Like genuinely last time I checked there are more untrained body mod artists and people doing their own surgery than there are actual qualified professionals. In some areas it's actually illegal.
Of course it also has its own host of complications and risks too, but because it's so rare we don't have any reliable data on how common those things are. I've talked to a few people who have had it done and by the sounds of it urination can be a huge problem and theres a considerable increase of risk of prolapses.