Boston Children’s Hospital paved the way for transgender care back in 2007 with its Gender Management Service program, the first of its kind in the country. And now, the top-ranked institution has once again taken a strong step forward with the first phalloplasty, or penis creation surgery, completed in Massachusetts.
Zack Hogle, 24, is the first patient at Boston Children’s Hospital, and the first in Massachusetts, to receive the surgery, WBUR reports.
Genital surgery, or gender affirmation surgery, is not the first step a transgender person undergoes in their path to transition. Other care options, like taking hormones and undergoing chest surgery, come first, according to Boston Children’s Hospital.
That was true for Hogle, who started his transition with testosterone shots, or T, and top surgery, according to WBUR. But undergoing phalloplasty, despite the complications, has led Hogle to be “the happiest I have been in my entire life,” he told WBUR.
But what exactly is phalloplasty? Let’s take a step back.
What is phalloplasty?
Phalloplasty is “the surgical creation of a penis,” according to Boston Children’s Hospital. The procedure involves surgeons harvesting “flaps” of skin from a donor site on your body, usually from your forearm or maybe your thigh.
That skin and tissue are used to form a penis and urethra. But even before that procedure, patients must undergo a hysterectomy, or uterus removal, at least three months prior to the phalloplasty.
Phalloplasty is complex, Boston Children’s Hospital says, and requires “significant recovery time” and an overall healing process that can take 12 to 18 months.
For Hogle, who underwent the phalloplasty at Boston Children’s Hospital back in January, the procedure took 14 hours, and he was in and out of the hospital for several weeks following the surgery with complications.
It was worth it, though, he told WBUR. “I am complete,” Hogle said. “I am who I should be. I can finally look down and see what I’ve been wanting for so long.”
Phalloplasty at Boston Children’s Hospital
Many trans men don’t pursue phalloplasty, experts say, because of how complicated and costly the procedure is, and because it’s not a surgery offered at every hospital.
While Hogle is Boston Children’s Hospital’s first and only phalloplasty recipient so far, the institution said it plans to have one or two such patients each month by next year.
The hospital said it’s the only pediatric hospital in the U.S. offering phalloplasty, but to be clear, the surgery is not available for children. At Boston Children’s Hospital, phalloplasty patients must be 18 or older and have been “living in their identified gender full time for at least 12 months.”
The first phalloplasty in Massachusetts completed thanks to Boston Children’s Hospital shows the progress made in transgender care and gender affirmation surgeries overall. Only two years ago, in 2016, Boston Medical Center announced that it would be the first in the Northeast to offer male-to-female gender affirmation surgery for transgender patients, and plans to eventually offer the female-to-male procedure (phalloplasty), which is more complicated.
Gender affirmation surgeries are offered in other states as well, including California, Philadelphia, New York and more. Brownstein & Crane, which offers gender reassignment surgeries in San Francisco, announced back in May that its surgeons have completed their 400th phalloplasty.
