Introduction. Phalloplasty using the radial forearm flap is currently the most frequently used technique to create the neophallus in transsexual men (formerly described as female‐to‐male transsexual persons). Although it is considered the gold standard, its main disadvantage is the eventual donor‐site morbidity in a young, healthy patient population.

Aim. The study aims to examine the long‐term effects of radial forearm flap phalloplasty in transsexual men and to evaluate aesthetic outcome, scar acceptance, bone health, and daily functioning.

Main Outcome Measures. Scars were evaluated with the patient and observer scar assessment scale, the Vancouver Scar Scale, and self‐reported satisfaction. Bone health was assessed using dual X‐ray absorptiometry and peripheral quantitative computed tomography, and daily functioning using a physical activity questionnaire (Baecke). These measurements were compared with 44 age‐matched control women.

Methods. This is a cross‐sectional study of 44 transsexual, a median of 7 years after radial forearm flap phalloplasty, recruited from the Center for Sexology and Gender Problems at the Ghent University Hospital, Belgium.

Results. We observed no functional limitations on daily life activities, a pain‐free and rather aesthetic scar, and unaffected bone health a median of 7 years after radial foreram flap phalloplasty. Over 75% of transsexual men were either satisfied or neutral with the appearance of the scar.