Metoidioplasty, metaoidioplasty, or metaidoioplasty (informally called a meto or meta) is a female-to-male sex reassignment surgery. Testosterone replacement therapy gradually enlarges the clitoris to a mean maximum size of 4.6 cm (1.6–2 in) (as the clitoris and the penis are developmentally homologous). In a metoidioplasty, the urethral plate and urethra are completely dissected from the clitoral corporeal bodies, then divided at the distal end, and the testosterone-enlarged clitoris straightened out and elongated. A longitudinal vascularized island flap is configured and harvested from the dorsal skin of the clitoris, reversed to the ventral side, tubularized and an anastomosis is formed with the native urethra. The new urethral meatus is placed along the neophallus to the distal end and