a procedureVaginoplasty

The testes are removed, the penile and scrotal tissue is dismantled, and a vaginal canal is made in the space between the bladder and the rectum, lined with penile skin turned inside out, with a scrotal skin graft, with a segment of sigmoid colon, or with peritoneum drawn down from the abdomen. A clitoris is built from glans tissue on its own nerve, the urethra is shortened and repositioned, and labia are formed from the remaining skin. The canal is held open afterwards by dilation, which is a daily obligation for a long period and then a permanent one.

Thailand has taken this operation for fifty years and it is the only country in this directory where a hospital publishes a full table of prices for it by technique. Yanhee Hospital in Bangkok lists nine nights and 420,000 baht for the skin-graft version, 580,000 for a sigmoid colon vaginoplasty, and 780,000 for the peritoneal ones. The same table prices the revisions — a failed colovaginoplasty replaced with a skin graft at 765,000 baht, a recto-neovaginal fistula repaired at 965,000 — which is a rarer piece of publication than the primary prices, and the two columns belong together.

Other long-established Thai clinics publish nothing. The Suporn Clinic in Chonburi states that it does not publish prices, and sets out a deposit and cancellation schedule instead. Chettawut Plastic Surgery Center in Bangkok publishes no package figure either; the only number on its surgery FAQ is an extra charge of 32,000 baht where the scrotal skin turns out to be insufficient and a groin graft is needed. Kamol Cosmetic Hospital names five techniques with their operating times and a stay of four to six nights, and no price at all.

Inference — that split is the useful thing on this page. Where a clinic's patients arrive through word of mouth in a community, the price is quoted in correspondence; where they arrive through a search engine, it is on the page. Neither pattern says anything about the surgery.

At the other end, what is published in London and San Francisco is a guide rather than a price. The London Transgender Clinic's list starts gender confirmation surgery at £31,160 for the penile-scrotal flap technique and £34,310 for colovaginoplasty, every line prefixed "Starts from", and states plainly that no exact price can be given before a consultation. The Gender Confirmation Center in San Francisco estimates vaginoplasty at 23,000 to 24,500 dollars and says hospital stay, in-hospital supplies and occupational therapy go into the quote while medications and travel do not.

Three things move this operation across borders: what it costs, how long the queue is at home, and whether the health system at home will do it at all. The third is law and administration rather than surgery, and it is on this directory's gender-affirming care access page, not here.

General anaesthesia, four to six hours by most published technique lists, and hospital stays that run longer than almost anything else in this directory: nine nights on the Thai price table, four to six on another Bangkok hospital's page. Permanent hair removal on the donor skin is done for months beforehand, not after. The canal is packed, then dilated: Chettawut's published instruction is a daily dilation routine for two years to hold the depth, dropping to two or three times a week after that, "for life". Discharge from hospital is not the end of the stay abroad — the first post-operative weeks belong to the surgeon who operated, and the stitches, the packing and the first complications all fall inside them.

As of 17 September 2026 the prices read off provider pages for this record span three countries and three kinds of document: a Thai hospital's fixed table with nights attached, a London clinic's guide prices with "Starts from" on every line, and a US practice's estimate with an inclusion sentence. None of the three publishes what a revision costs at home, and only the Thai table publishes what a revision costs where the operation was done.