also called gender-affirmation or gender-affirming surgery. This can take different forms, including the removal of breasts — a mastectomy — and the altering of the genital region, known as “bottom” surgery. Examples of bottom surgery include: removal of the uterus, known as a hysterectomy removal of the vagina, known as a vaginectomy construction of a penis through metoidioplasty or phalloplasty In this article, we describe female-to-male gender-affirming surgeries. We also discuss recovery and what to expect from a transgender penis.