## Abstract

Gender confirmation surgery for the MTF individual has evolved and improved over time, particularly in terms of form and function. While initially surgeons concentrated on creating a vulva that functioned for receptive penetrative intercourse, in time consumer demand and improved surgical techniques have resulted in a vulva that is esthetically pleasing, functional, and sensate. This first-person account shows how techniques evolved in a critical two-year period between 1974 and 1976.