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Metoidioplasty, metaoidioplasty, or metaidoioplasty[2] (informally called a meto or meta) is a female-to-male gender-affirming surgery.[3]
Testosterone replacement therapy gradually enlarges the clitoris to a mean maximum size of 4.6 cm (1.8 in)[4] (as the clitoris and the penis are developmentally homologous). In a metoidioplasty, the urethral plate and urethra are completely dissected from the clitoral corporeal bodies, then divided at the distal (far) end, and the testosterone-enlarged clitoris straightened out and elongated. A longitudinal vascularized island flap is configured and harvested from the dorsal skin of the clitoris, reversed to the ventral side, tubularized and an anastomosis (connection) is formed with the native urethra. The new urethral meatus is placed along the neophallus (newly formed penis) to the distal end and the skin of the neophallus and scrotum reconstructed using labia minora and majora flaps.[5] The new neophallus ranges in size from 4–10 cm (1.6–3.9 in) (with an average of 5.7 cm (2.2 in)) and has the approximate girth of a human adult thumb.[6]
The term derives from meta- "change", Ancient Greek αἰδοῖον, aidoion, 'genitals', and -plasty, denoting surgical construction or modification.[2]
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