Thomas Manning made US medical history earlier this May, 2016.  An unassuming, bank currier hailing from Halifax, Massachusetts became the first US recipient of complete penile transplant.  No, Mr. Manning is not a transgender male, but his successful transplant is an encouraging development for transgender males desiring to have a full working penis, to complete their transition.

We’re cautiously optimistic.  It’s uncharted waters for us.

Curtis Cetrulo, Dicken Ko -penile transplant
Surgical team members: Dr. Dicken Ko(left) & Dr. Curtis Cetrulo

This experimental surgery lasted 15 hours.  Plastic and reconstructive surgeon, Dr. Curtis L. Cetrulo said, “We’re cautiously optimistic.  It’s uncharted waters for us.”  Dr. Cetrulo was also the head of the surgical team performing the surgery.  The surgery is part of a research program initially designed to help combat veterans, cancer patients and accident victims.  Transgender patients are not being considered at this time.

Thomas Manning will have to take anti-rejection drugs for the remainder of his life.  This has concern for his future as these drugs are potentially cancer causing, and tax the renal system, specifically the kidneys.  These side effects were less of a concern to him, rather than living the rest of his life without his penis.  “I want to go back to being who I was,” Mr. Manning said.

I want to go back to being who I was

Manning -penile transplant
Thomas Manning

Out of bed, and in a chair days after the operation, he added that he felt well and had experienced hardly any pain.  If recovery goes well, Thomas should be able to urinate in the next couple of days, which is about a week out from surgery.  Doctors are cautiously optimistic he will also be able to experience a full erection in a couple of months.

With all this encouraging news, the implications are not lost on the transgender community.  Trans-Males are closer to having the option of a experiencing a complete maleness, in the physical sense.  However, transplanting the organ onto a place where it naturally resided is wholly different to transplanting the organ genetically not designed for it.  Or so it would seem….

Are there enough developmental similarities between a natal vagina and a natal penis to be compatible?  It is quite possibly so.

The vagina, however, has nearly double the amount of nerve endings than the penis, with the majority clustered in the clitoris.  I would suspect this could lead to feeling numbness or dead areas around the grafted penis.  The muscle structure is close to identical as well.  I would estimate the challenge would be the urethra graft, essentially extending the natal feminine urethra to the donated organ.

Similar vaginal and penile structures

  • Bulbospongiosus muscle
  • Ischiocavernosus muscle
  • External Urethral Opening

Inter-relational vaginal and penile structures:

vaginal                                                    penile

  • traverse peritoneal muscles                perineal muscles, membranes and body
  • glans of clitoris                                  glans of penis
  • corpus cavernosum of clitoris*            male corpus cavernosa*
  • clitoral hood                                      penile foreskin
  • vestibular bulbs                                 corpus spongiosm
  • labia minora and majora                     scrotum

vaginal anatomy -penile transplantpenis anatomy -penile transplant

*these areas engorge with blood when aroused

Beyond the physical recovery and ensuing education on using their new apparatus, trans-males will also have added psychological recovery.  This is amplified by the fact that not only have they physically transitioned across the final frontier of GRS medicine, they also have to come to terms with having a cadaver penis attached to their body.  This might not be as difficult to rationalize, given the fact that transgender males view their breasts as foreign bodies, anxious to have them removed.  Though here I can only speculate.

Given the amount of similarity between the male and female sexual organs, grafting a donated penis onto a natal vagina seems excitingly plausible to me.  I hope for my transgender brothers who see this procedure as a necessity, their reality comes true.

mir, irini, peace, amn,

-jahn