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The most reliable method of preventing hair growth in the vagina is to perform scrotal electrolysis, at least three full clearings 8-12 weeks apart, depending on electrolysist preference and hair type and distribution.Surgeons should provide a diagram of the specific area for clearance.

Scrotal skin has abundant hair follicles and it is possible to transfer skin with sparse hair growth into the vagina unless hair is removed in advance.In this technique, a vaginal vault is created between the rectum and the urethra, in the same location as a non-transgender female between the pelvic floor (Kegel) muscles, and the vaginal lining is created from penile skin.An orchiectomy is performed, the labia majora are created using scrotal skin, and the clitoris is created from a portion of the glans penis.Typical depth is 15 cm (6 inches), with a range of 12-16cm (5-6.5 inches); in comparsion, typical vaginal depth in non-transgender females is between 9-12cm (3.5 to 5 inches).In the case of prior circumcision a skin graft, typically scrotal in origin, may be required.Specifically, this secondary procedure also allows the surgeon to deal with differences in healing, such as revision of the urethra, correction of any vaginal webbing or persistent asymmetries, or revise scars that are unsatisfactory.

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