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Transgender Surgery

At The University of Kansas Health System, we take a multidisciplinary approach to gender-affirming surgical care, combining plastic surgery, reconstructive urology and gynecology. Our goal is to provide patients with a patient-centered surgical experience while having the expertise and resources of a large academic institution. Safety and aesthetics are of the utmost importance.

Our board-certified, sub-specialized experts provide gender-affirming surgery, also known as sex reassignment surgery, at The University of Kansas Hospital in Kansas City.

We provide concierge service for gender-affirming surgical consultation. Contact Judy Gay, RN, nurse program coordinator, at 913-588-8553.

Our services

  • Facial feminization includes combined procedures to give the face a softer, more traditionally feminine appearance. This can include surgeries for both bony and soft tissues of the face, neck and thyroid cartilage. FFS is often complemented by laser hair removal.

  • Mastectomy and chest contouring

    Female-to-male top surgery, or FTM top surgery, removes unwanted breast tissue to create a more masculine chest appearance. There are several surgical techniques that may be used based on the patient’s physique and amount of chest tissue present. The most common technique is bilateral mastectomy with free nipple grafts. Some patients may be eligible for a peri-areolar, or keyhole, technique that minimizes scarring. These procedures are offered as a drainless technique.

    Breast augmentation

    Breast augmentation procedures enhance the size, shape or fullness of the breasts. Ideally the patient will have taken hormone therapy for at least 12 months before undergoing breast augmentation. Hormone therapy results in nipple growth and development of some breast tissue, which means surgery is likely to be more successful, with better cosmetic results.

  • In 2018, The University of Kansas Health System began offering gender-affirming surgery (bottom surgery).


    A feminizing genital surgery that includes several procedures performed at once. We use a penile inversion technique in which the penis is turned inside out to form the inner walls of the vagina. The head of the penis is then used to create a clitoris. Outer and inner labia are formed, and the urethra is shortened and repositioned. The surgery results in fully functioning external female genitalia that allows sexual penetration, orgasm and urination. Preoperative electrolysis or laser hair removal from the scrotal sac is recommended. Follicles will be scraped and electrolyzed during surgery, but hair growth cycles prevent removing all dormant hair.


    The clitoris is "released" to give the appearance of more length to the phallus. The final result is a normal appearing, but very small, penis. This surgery can be performed in conjunction with a vaginectomy and a hysterectomy with bilateral salpingo-oophorectomy. Urethral lengthening can also be done at the same time, or at a later time, to allow the patient to stand to urinate. The labia majora becomes the scrotal sac and customized solid silicone testicular implants can be placed. The surgery is minimally invasive, and sensation to the clitoris remains intact.


    The formation of a phallus using skin taken from another spot on the body: sometimes the flank, lower abdomen or forearm. The principal advantage to this procedure is that it creates a penis of significant size and bulk that can accommodate an erectile device to allow penetrative sexual intercourse. Urethral lengthening can also be done at the same time, or at a later time, to allow the patient to stand to urinate.

  • Body feminization can be done to achieve an hourglass figure. Typically, this procedure involves trunk liposuction and buttocks augmentation. Fat is removed from the waist, abdomen, love handles and mid/lower back. This fat can then be transferred to the buttocks area to form a shapely, feminine backside – a procedure known as the "Brazilian butt lift."

    Body masculinization can help a person attain the classic V-shaped figure. Certain areas of fat storage, such as the hips, legs and buttocks, can be difficult to change through diet and exercise alone. Contouring can help achieve a broad and defined upper torso, trim waist and minimal fat in the lower body area.

Gender-affirming surgery criteria

Patients should be fully prepared – physically and mentally – as they prepare for gender-affirming surgery.

For concierge gender-affirming surgical consultation services, contact Judy Gay, RN, transgender clinic coordinator, 913-588-8553.

Patient Terrell Smith

A leader in transgender medicine

For years, we have provided facial feminization (FFS) and mastectomy and chest contouring (top surgery) for patients in Greater Kansas City and beyond.

Terrell Smith discusses his transgender journey and the care he received during his transition.

Read Terrell's story

Our transgender medicine specialists

Judy Gay

Judy Gay, RN, BSN

Nurse program coordinator