Genital construction in female-to-male transsexuals also should involve giving the labial region a scrotum-like appearance. A review of the literature on this subject is given. In our hospital, the construction of a scrotum in which testicular prostheses are implanted has been performed usually in combination with lengthening of the pars fixa of the urethra. A bifid scrotum is constructed using a V-Y advancement of the labial skin. Although implant expulsion (in 7 percent) and dislocation of implants (in 11 percent) were encountered in this series of 50 patients, the technique itself is easy to perform and seems to have few major drawbacks. The scars are small and hidden in the scrotal folds and hair. Tissue expansion prior to implantation of the testicular prostheses in the labial skin has proven to be unnecessary with this technique.