Exploring experiences of metoidioplasty: a qualitative study

Background: Genital gender-affirming surgery is often considered an important step in the gender transition process. However, there is currently limited information available about the full surgical trajectory of trans men who choose to undergo metoidioplasty. Aim: This qualitative interview study explored the multifaceted experiences of transmasculine individuals who undergo metoidioplasty. Method: We conducted in-depth, semi-structured individual interviews with 15 participants who had previously undergone metoidioplasty at the national center in Norway. The interviews covered topics such as the participants' motivations prior to surgery, their experiences throughout the surgical process and the impact on their daily life. The interview data were analyzed via thematic analysis using the framework of van Manen's hermeneutic phenomenology, with the aim being to understand how individuals make sense of their lived experiences. Results: Three subthemes were developed during the analysis-namely, metoidioplasty as an important step toward affirming masculinity, the process of adjusting to the surgical outcome and the impact of the procedure on daily life. Clinical implications: The findings of this study provide valuable insights for health professionals and patients concerning shared decision-making before undergoing genital gender affirming surgery in regard to expectations and outcome. Conclusion: This study shows that metoidioplasty represents more than a physical change; rather, it is a significant step toward affirming one's masculinity and integrating one's gender identity. The subsequent transition into everyday life involves adjusting to the bodily outcomes of the procedure and navigating psychosocial challenges. These findings highlight the importance of comprehensive follow-up care that supports both the physical and psychosocial dimensions of this process.