A transgender man may become the first to receive a penis transplant. Doctors say it would be a 'quantum leap' for surgical medicine.

Crystal Cox/Business Insider
  • Surgeons are looking to perform the world's first-ever penis transplant on a transgender man.
  • Dr. Curtis Cetrulo, a plastic and reconstructive surgeon at Massachusetts General Hospital, told MedPage Today it would be a "quantum leap" for surgery.
  • Only a handful of successful penis transplants have ever been performed on cisgender men who have lost their penises.
  • Dr. Justin Dubin, a urology resident at the University of Miami, told Insider this procedure may come with especially difficult complications because penis transplants are already difficult on cisgender men.
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A team of Massachusetts surgeons is preparing to perform the world's first-ever penis transplant on a transgender man.

During the procedure, surgeons would take the penis of a deceased donor and transfer it onto a transgender patient who was assigned female at birth.

As there are only a handful of successful penis transplants that have been performed on cisgender men (men who were assigned male at birth) who lost their penises in war or to cancer, this surgery could be groundbreaking for the future of penile transplants.
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This transplant would be historic because it would require working with the anatomy of a person who had never had a penis to attach the donor organ rather than someone who had lost a penis.

"This would be a quantum leap if you were able to transplant a real penile structure," Dr. Curtis Cetrulo, a plastic and
reconstructive surgeon at Massachusetts General Hospital, told MedPage Today.

There have only been a few successful penis transplants on cisgender men

There have only been five penis transplants performed in history, all on cisgender men, and only three of those have been considered successful — allowing the recipient to pee and maintain erections — according to Dr. Justin Dubin, a Urology Resident at the University of Miami.
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The world's first successful penis transplant was performed in 2015 by a team of South African doctors from the Stellenbosch University in Cape Town and Tygerberg Hospital. Doctors told CNN they used the same techniques used during the world's first face transplant for the procedure.

The first team that performed a successful penis transplant on a cisgender man in the US in 2016 is the same team debating whether or not to perform a transplant on a transgender patient. Dubin told Insider penis transplants are especially complicated to perform successfully because of the microscopic nerves and blood vessels that need to be connected during surgery.
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"The penis as an organ has relatively smaller sized blood vessels compared to other organs like the liver or the kidney," Dubin told Insider.

"The penis also requires connecting not only arteries and veins to function appropriately but also requires connecting the urethra which you urinate out of as well as small nerves to help penile sensation, erections, and orgasm."

Penis transplants could be revolutionary for transgender patients

Performing a penis transplant on a cisgender patient is extremely difficult, but doing so on a transgender patient presents the separate complication of differing anatomy. Helping the patient to reach a point where they can orgasm and urinate requires an entirely different and novel approach.
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That's on top of the usual risk of infection, as with any transplant. What's more, the patient will need to be on immunosuppressant drugs for the rest their life, to make sure the body doesn't reject the transplant, which carries health risks.

Dubin told Insider he wasn't sure how much demand there would be for trans patients to get a penis transplant in the future. There are other, good options for bottom surgery like phalloplasty and metoidioplasty, both of which use the patient's own anatomy to construct a penis and don't require immunosuppressant drugs.

"Making this kind of decision on patients who have no other options and require organs like kidneys or livers is easy, but when you are talking about transplanting an organ like the penis, especially when we have successfully demonstrated that a functional penis can be constructed from tissue from the patient's own body, the decision to transplant becomes more complicated," Dubin said.
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However, a successful procedure could be revolutionary, providing an entirely new option for both transgender patients and cisgender patients.

"Performing the surgery may be possible, but to perform the surgery while successfully achieving all these functional outcomes [orgasm, erection, and urinating] would be remarkable," Dubin told Insider.

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