May 10, · Bottom surgery generally refers to one of three surgeries. The first, vaginoplasty, is typically pursued by transgender women and AMAB (assigned male at birth) nonbinary people. Phalloplasty or Author: Sasha Clary. What is transfeminine bottom surgery? The goal of transfeminine bottom surgery is to transform the male genitalia and reconstruct it into that of a female. Transfeminine bottom surgery is typically performed as a single stage procedure. There are many techniques used to perform bottom surgery, and the most common is the penile inversion vaginoplasty.