This technique will change the external appearance of male external genitalia to female external genitalia with natural looking and functional organs;

1. The sensitive clitoris with intact nerve and blood supply derived from glans penis.
2. The neovagina with vaginal lining from inverted penile and scrotal skin.
The vaginal depth will be 4 inch or more depend on the penis size.
3. The labia majora from scrotal skin and labia minora from prepuce and penile skin.
4. The female urethra with normal function.

The operation time is about 3-4 hours and after operation there will be urethra catheter and vaginal pack left with will be removed in 5-7 days. The external genital appearance will be looked good in about 2 weeks and sexual activities after 2 months.

The guidelines suggested by the Harry Benjamin Dysphoria Association and the American Psychiatric Association give the following criteria for the diagnosis of transsexualism:

1. A sense of discomfort and inappropriateness about one's anatomical sex.
2. A wish to be rid of one's genitals and to live as a member of the opposite sex.
3. The disturbance has been continuous (not limited to periods of stress) for at least 2 years.
4. An absence of physical intersex or genetic abnormality.
5. No other mental disorder such as schizophrenia.

At the time of referral for surgery, the patient should fulfill the following:
1. A persistent wish for at least 2 years to change gender.
2. A psychiatric assessment over a period of at least 2 years.
3. Demonstrable ability to live adequately in the chosen gender role for at least a year, working and self- supporting in this role.