There are a few ways that individuals born female can change their sex, but it should first be noted that, at least in comparison to male-to-female surgery, female-to-male is considerably lacking, with the end results of even the most extensive surgery often not functioning correctly or looking somewhat 'off'. Not to mention that it is prohibitively expensive, sot that many FtM's simply choose to forgo surgery altogether.
But for those who do want surgery, there are several types:
1) Masectomy. The most important to most FtM's, this is the removal of breasts. It can be done various ways, depending on the size of the breasts to begin with (if they're small enough, the fat can be suctioned away through small incisions near the armpit; otherwise, long cuts will have to be made beneath the breast, the fatty tissue scraped away, the excess skin removed and the skin tightened over the now flat chest. The former is invisible; the latter leaves long visibile scars).
2) Metoidioplasty. When FtM's take the male hormone testosterone, their clitorises begin to grow in size and length (even growing a tiny 'head' like a biological penis). Though it varies, the new penis (often called a 'neophallus') can reach up to three inches, though it's more often only one to two. For some FtM's, this may be enough for them, and they don't take any further steps. But for those who want more, a metoidioplasty is possible. This surgery doesn't actually increase the size of the neophallus; no extra flesh is added. Instead, it cuts one of the tendons up top on the neophallus to reveal the extra length, so that it hangs lower and looks larger. It will be the exact same size erect, however- it's only flaccid that it seems to be bigger. Interestingly enough, biological men can get the same surgery- cutting a tendon above their penis- to make it hang lower and look bigger, as well.
3) Some FtM's may choose to have a urethral lengthening as well, which extends the urethra through either the neophallus or the phalloplasty (see below) so that they can actually pee through their penises the way that biological men do, rather than still from their 'vaginas'.
4) Scrotoplasty. While having a little neophallus is nice, many FtM's crave testicles, and there is a surgery for that. In a scrotoplasty, surgeons take the labia and stretch them around small, round silicone implants, to create a ballsac and non-functioning testicles.
5) Phalloplasty. The most expensive and fraught-with-danger surgery, phalloplasty seeks to build an entire penis out of your flesh. While many people think "But why don't they just take penises and sew 'em on?", it's simply not medically possible. There are so many tiny, intricate blood vessels and other parts to hook up that it's an amazingly hard surgery, not to mention that any transplant has high chances of the body rejecting it. Not to mention that I'd wonder where in the world you'd "harvest" penises from! Instead, phalloplasties are created from the patient's own skin- usually from the inner forearm or the thigh. It's difficult to describe if you don't have a medical background, but essentially, the skin is rolled and blood vessels are hooked up to keep a healthy flow as the skin heals together, forming an attachment. It creates something similar to- but also significantly different from- a biological penis. It cannot get hard on its own (FtM's can have an implant put in to let them give themselves an erection at will, however, the same that impotent biological men use), but should have all the sensation a penis ought to, although it obviously won't be able to ejaculate.
6) Hysterectomy. Although testosterone will dry up and stop menstruation (the bane of most FtM's), many still feel that they are not fully male when they have the inner workings of a woman (not to mention that the prolonged exposure to testosterone seems to be related to uterine cancer in FtM who still have their wombs). So many choose to get a hysterectomy as well.
Hope that helps you better understand!
· 1 decade ago