The information obtained from the literature suggests that phalloplasty is starting to become accepted at some centres as part of the standard of care for female-male transsexual SRS. There have been recent technical improvements, though the procedure remains demanding, as does the necessary associated counselling of patients. Phalloplasty appears to remain a highly specialized procedure, with successful outcomes linked to appropriate patient selection, counselling and follow-up, and to high levels of surgical expertise.