Phalloplasty is a type of surgery that takes existing skin, tissue, and nerves from surrounding areas on a patient’s body to repair or form a neophallus, or a new penis structure. In 1946, Harold Gillies, a plastic surgeon who practiced in England, performed one of the first modern phalloplasties that entailed creating an entire neophallus for a transsexual, called transgender as of 2022, man in London, England. The reconstructive need for phalloplasties started as a result of treating blast wounds during World War I and World War II. The techniques from that time allowed Gillies to perform a phalloplasty with urethral lengthening. Lengthening the urethra allows the patient to use the neophallus to urinate, for a transgender person as a means of affirming their gender identity. Phalloplasty procedures improve the quality of life for people who have congenital conditions, physical trauma, or are seeking gender affirmation surgery.

No-scalpel vasectomy, or NSV or keyhole vasectomy, is a surgical method of sterilization that involves puncturing the skin of the scrotum to access the vas deferens, a tube that carries spermatozoa, or sperm, from the testes to the penis. The surgeon performing the procedure blocks the flow of sperm through the vas deferens, sterilizing the patient. NSV is a less invasive procedure, as it does not use a scalpel to make a deep cut on sensitive scrotal tissue. Typically, urologists perform NSV with the purpose of rendering the patient sterile while not altering other functions of the testes, scrotum, and penis. Li Shunqiang developed the technique in China in 1974 as a less invasive method of vasectomy for male patients. Li’s development of NSV provided an alternative method to vasectomies that rely on making incisions into the scrotum with a blade. NSV gained wide use as a sterilization technique, providing a path for males to take greater responsibility for contraception and family planning.

In the United States, most people are assigned both a biological sex and gender at birth based on their chromosomes and reproductive organs. However, there is an important distinction between biological sex and gender. Biological sex, such as male, female, or intersex, commonly refers to physical characteristics. Gender refers to the socially constructed roles, behaviors, and actions people take on, usually in relation to expectations of masculinity or femininity. As of 2022, there is disagreement over the relation between sex and gender. People’s biological sex and gender greatly influence the way they understand themselves, as well as how others treat them and how they interact with society. Moreover, some people’s gender differs from what they were assigned at birth, and they face discrimination, harassment, and violence. Evolving understandings of gender and sex in the US have created more ways for people to live and express their gender identities.

Harry Clay Sharp was a surgeon who performed one of the first recorded vasectomies with the purpose of sterilizing a patient. Sterilization is the practice that makes a person unable to reproduce, and vasectomy accomplishes that by severing the vasa deferentia, the sperm-carrying tubes in the male reproductive system. Historically, sterilization procedures have varied in techniques, goals, and risks, but Sharp’s method of vasectomy allowed restriction of a patient’s reproductive functions without significantly affecting other bodily functions. Historians have associated Sharp’s use of the procedure, primarily on prison inmates, with eugenics, a movement with the goal of bettering humans via selective reproductive practices. With vasectomy, Sharp was able to sterilize people whom he did not deem fit to reproduce. Beyond simply pushing forward a new surgical method of sterilization, Sharp’s political advocacy led to the use of his technique as a method of eugenicist control over human reproduction, especially in Indiana.

Harold Delf Gillies performed one of the first sexual reassignment surgeries, termed gender affirmation surgeries as of 2022, on record in 1946 in London, England. He also practiced modern plastic surgery and helped distinguish it as a new branch of medicine in London, England, starting in the early 1900s. Gillies’s work focused initially on facial reconstructive surgery, particularly during both World War I and World War II. Gillies created newer and more efficient techniques that later became standard procedures for reconstructive and cosmetic surgeries. Gillies, along with two members in his practice, standardized over 11,000 techniques, and beginning in 1946, he performed one of the first successful phalloplasties on a transgender man, where he formed a new penis from the patient’s existing skin and tissue.

Ernst Gräfenberg was a physician and researcher who studied sexology, the study of human sexuality, in both Germany and the United States during the first half of the twentieth century. Gräfenberg researched the use of intrauterine devices as a form of contraception, and he developed the Gräfenberg ring. The Gräfenberg ring was one of the first intrauterine devices that effectively prevented pregnancy without causing infection, and it became the forerunner of all modern intrauterine devices, or IUDs. Gräfenberg also studied the role of the urethra in female orgasm. He was one of the first researchers to discuss female pleasure in a scientific manner, and, more specifically, he was one of the first to write about the erogenous zone on the anterior vaginal wall, colloquially called the G-spot. Through the technology he developed and the ideas he proposed, Gräfenberg advanced knowledge of female anatomy, pleasure, and reproduction, enabling researchers and professionals to better understand and cater to females’ reproductive and sexual needs.

Gender-affirming mastectomy is a type of surgery that removes breast tissue, tightens the skin, and can adjust nipple placement to provide the desired results of a more masculine-looking chest. Mastectomies started as a way for surgeons to remove breast cancer and tumors from the breast tissue. However, as of 2022, surgeons also use the procedure as a means of gender-affirming surgery for transgender and non-binary, hereafter TNB, individuals. If a person identifies as transgender, their gender identity differs from the sex they were assigned at birth and the gender they were most likely raised as, which can produce gender dysphoria, a condition that can last a lifetime. Non-binary individuals may have a similar experience, but they identify outside of or between the identifiers of man and woman. Gender-affirming mastectomy, sometimes called top surgery, improves the quality of life for people who seek the appearance of a masculine chest to both better integrate themselves into society and lessen the mental and emotional burden of gender dysphoria.