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The testicles are removed and discarded.
The new vaginal cavity is carved out in the space between the urethra and the rectum.
A penile prosthesis (surgical dildo) is inserted into the cavity to hold the shape.
The skin is removed from the penis. This skin forms a pouch which is sutured and inverted.
A triangular piece of glans penis (the bulbous tip) is removed to become the clitoris.
The urethra is removed, shortened, and prepared for repositioning before the remaining parts of the penis are amputated and discarded.
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