Dr Bowers developed her one stage procedure with basic principles of embryology in mind. As everyone has female genitalia early in gestation, the goal of the procedure is reverse the current anatomy to its earlier configuration. Although the procedure is technically a version of the original ‘penile inversion technique’ the current version is highly modified including the use of scrotal skin grafting to line the vagina and numerous other advances that continue to evolve on an ongoing basis.


For GRS, the testicles are removed (if present) and the neo-vagina is created, using the inverted penile skin and part of the scrotal skin to line the vagina. The urethra is shortened. The clitoris is formed from part of the glans of the penis and is sensitive, allowing for most patients to retain their ability to achieve an orgasm.   The surgery lasts approximately 3.5 hours. Breast augmentation and/or tracheal shave (reduction of the “Adam’s apple”) can also performed at the time of the primary genital reassignment surgery, if desired.


Patients stay 3 nights at Mills Peninsula Health Services. Three days after discharge, patients return to clinic where the urethral catheter and vaginal packing are removed and vaginal dilation is demonstrated. Complete recovery takes 12 weeks but most patients are able to resume working in 4-6 weeks, depending of their occupations.


Cost can vary depending upon the need for grafting (rare) and patient weight.  Robin can help and Janet can help with insurance authorization.


Complications are rare in our experience especially in the setting of our high surgical volume.  The vast majority of complications that we encounter are minor and can easily be treated by a local primary care provider. You will have the personal cell phone number of Dr Bowers upon discharge and you are strongly encouraged to communicate with them with any concerns or questions.