"Gender affirming care"

 This is a girl’s forearm. Her muscles have been farmed to create a fake phallus that doesn’t function.

They will try to make her a fake urethra. She’ll probably be incontinent, she will certainly never function like a man. And her muscles won’t grow back.

Google ‘phalloplasty’. --- [Dr. Anastasia Maria Loupis: Twitter]

Phalloplasty involves using skin flaps, which are areas of skin moved from one area of the body to another. The skin flap is then reshaped, contoured and reattached to the groin to create the penis. There are three approaches the surgeon may use to construct the penis, using skin from the arm (radial forearm free flap), leg (anterolateral thigh flap) or side (latissimus dorsi flap).

A radial forearm free flap (RFFF) involves taking the skin, fat, nerves, arteries and veins from the patient's wrist to about halfway up your forearm to create the penis. Typically, the surgeon will use the patient's nondominant hand so it is easier for the patient to recover and return to your day-to-day activities.

During surgical consultation, the doctor will check the blood flow to the patient's arm and hand noninvasively. This involves temporarily putting pressure on arteries then releasing the pressure to test blood distribution in the arm and hand.

There are three stages to this procedure.

Stage 1: The first stage of an RFFF approach is creating the penis using tissue from the forearm. The area where the forearm tissue is taken will require a skin graft. This may occur at the time of the initial phalloplasty surgery, or it may occur three to five weeks afterward. If it occurs later, patients will have a temporary skin covering over the forearm to help it heal.

Stage 2: The second stage, scheduled about five to six months later, may include lengthening the urethra to allow for urination out of the tip of the penis, creating the scrotum and removing the vagina, and other procedures depending on the patient’s individualized plan.

Stage 3: The third stage of surgery involves putting in place testicle implants and an erectile device to help the patient achieve an erection. The third stage typically takes place 12 months after the second.

[Johns Hopkins]