First the ureter is catheterised
 

then the skin of the penis and scrotum is cut and removed
 

and the testicles are removed
 

leaving some of the skin of the scrotum
 

the urether is shortened
 

and the erectile tissues removed
 

now comes the most critical incision: the penile nerves are separated
 

these nerves must be preserved intact to enable orgasm
 

separation is complete
 

the vaginal cavity is formed
 

Rather shallower than in genetic females, about 12 cm; the remains of      the penis are cut off
 

and the scrotal skin tissue is inverted
 

and forms the vaginal lining
 

  A stent is inserted to prevent the vagina from growing together and closing

 

and a special adhesive is injected
 

to bond the inverted scrotal tissue to the abdominal flesh
 

finally the labia are formed, and also the clitoris from the glans.