Gender Nullification

Dr. Davis is one of just a handful of North American surgeons who have been performing gender confirmation surgeries for more than 20 years. However, not all gender patients desire a complete transition. For his gender non-conforming patients, Dr. Davis also performs gender nullification, also known as male to eunuch or “smoothie” procedures. The procedure includes a complete penectomy, orchiectomy, a reduction of the scrotal sac, and shortening of the urethra. The goal is to leave the area as a smooth unbroken transition from the abdomen to the groin. Although, an inconspicuous midline scar and shortened urethra will still be present. Dr. Davis does also offer the option of retaining the highly sedate distal penile tissue (which normally makes up the clitoris in a typical gender reassignment procedure), which he “buries” in the deep tissue of the lower mons above the urethra, akin to a “hidden” clitoris. This area does not affect the final smooth appearance of the area but does offer significant extra sensory tissue to aid in orgasmic stimulation. Of course, this option is left entirely up to the desires of each patient.

Preparation

In preparation for any procedure. Dr. Davis and his staff will want to perform a complete history and physical and ensure you are in the best health possible to undergo a surgical procedure and anesthesia. It is vitally important to refrain from smoking or using any tobacco products for at least a month prior to your scheduled surgical date. In addition, we will require you to refrain from taking aspirin or any NSAID's (ibuprofen, and the like), all which can 'thin' the blood and lead to peri-operative bleeding. If you have other medical conditions of particular concern, these will be addressed in the weeks leading up to your surgery date also. We generally ask that you refrain for taking any herbal medicines, vitamin supplements, or iron or fiber-containing products. In addition, the day prior to surgery, you will need to undergo a 'bowel prep' which essentially cleans out your intestinal system, and you will start a clear liquid diet that day also. Instructions can be found here:

Out of Town Patients

For those patients coming from out of the area, there is additional information regarding local accommodations, directions, and the like in our FAQ section. Depending on your initial consultation via phone, FaceTime, Skype or the like, you may be asked to obtain medical clearance for your procedure by your regular hometown physician prior to arriving. That way, any required lab work can be completed in a timely manner prior to your surgical date and Dr. Davis can assess your overall health and fitness for surgery. Patients should plan on arriving one or two days prior to their surgical date, and then, staying for a few days after their procedure as their time and schedule allow. In any event, Dr. Davis is committed to staying in close touch, especially during the early postoperative period when healing well is essential and during a time when patients are getting acquainted with their new anatomy.

Recovery

The procedure is generally performed on an outpatient basis, allowing a home recovery. However, whether for medical reasons, or patient preference, it can be performed in-hospital with an overnight stay. Either way, patients will have a Foley catheter draining their bladder for a couple of days post-operatively.

Results

While, the surgical results are immediately apparent, it takes several weeks to months to heal completely. The groin will be quite swollen initially. Patients can generally resume sexual activity in 1 to 2 months.

Follow Up

Patients will generally have several appointments in quick succession following their surgery, with the first being on the first post-operative day. Dr. Davis and his staff are committed to the care and well being of every patient. Dr. Davis sees his patients frequently in the postoperative period and continues to follow their progress for an extended period. The staff is also available to patients for any future needs they may have.