With respect to gender-affirming surgeries for transgender female to male patients, phalloplasty is currently the most common procedure for those wanting the ability to have penetrative intercourse, using an implanted device (such as the pneumatic pump) to allow for erectile function.

Metoidioplasty is an alternative where the clitoral tissue is used to create a phallus that has intact sensation and ability to engorge/become erect, but will often not result in a size adequate enough for penetrative intercourse (generally only a few centimeters).

In Alberta, patients are sent to Montreal for gender-affirming bottom surgeries.