San Francisco
2299 Post St. Suite 207
San Francisco, CA 94115
(415) 530-5335
Los Angeles
1317 5th St #300
Santa Monica, CA 90401
(310) 751-5886
Michael H. Safir, MD, is a board-certified reconstructive urologist at Align Surgical Associates whose practice is dedicated exclusively to gender-affirming bottom surgery. He sees patients in San Francisco and Los Angeles, bringing more than 25 years of reconstructive urology experience to primary and revision procedures for transgender, nonbinary, and gender-diverse patients.
As one of the few urologists worldwide with fellowship training in both male and female genital reconstruction, Dr. Safir brings rare depth to this highly specialized work. Whether his patients’ goals are masculinizing, feminizing, or more individually defined, he focuses on creating anatomy that heals well, functions reliably, and feels right for them over time.
Explore Surgical Options with Dr. Safir
Credentials At A Glance
Education & Training
- Fellowship – Reconstructive Urology and Trauma, University of California, San Francisco
- Fellowship — Female Urology, Neuro-urology and Urodynamics, University of California, Los Angeles
- Residency — Urology, Northwestern University Medical School
- Surgical Internship — Northwestern University Medical School
- Doctor of Medicine (MD) – Northwestern University Medical School
- Undergraduate – Northwestern University
Professional Affiliations
- World Professional Association for Transgender Health
- American Urological Association
- Western Section, American Urological Association
Credentials
- Board Certification – American Board of Urology
- Subspecialty Certification — Urogynecology and Reconstructive Pelvic Surgery, American Board of Urology
- Licensure – Physician’s and Surgeon’s License, Medical Board of California
A Rare Training Path in Reconstructive Urology
Dr. Safir’s training path is unusual even within reconstructive urology. After completing his urology residency and surgical internship at Northwestern University Medical School, he pursued two separate year-long fellowships: reconstructive urology and trauma at UCSF and female urology, neuro-urology, and urodynamics at UCLA.
Together, these fellowships gave Dr. Safir a rare foundation in both male and female genital reconstruction. Over more than 25 years in reconstructive urology, his career has become increasingly specialized, culminating in nearly a decade devoted exclusively to gender-affirming procedures.
Reconstructive Precision Meets Aesthetic Judgment
In bottom surgery, a decision made for contour or proportion can affect healing, support, or urinary function, while a decision made for function can shape how natural the final result appears. Dr. Safir’s background in reconstructive urology and aesthetic genital surgery helps him make these decisions with both priorities in view.
For patients, this means he is looking at the result as a whole: not just whether the anatomy can be created or repaired, but how it will work, heal, and come together in daily life.
Special Clinical Interests
Dr. Safir’s clinical interests reflect the work he does every day: highly specialized bottom surgery that draws on reconstructive urology, aesthetic genital surgery, and decades of experience with complex primary and revision care.
Microvascular Phalloplasty
Dr. Safir is one of the most experienced phalloplasty surgeons in the United States. He has performed more than 230 procedures, including microvascular phalloplasty, which involves carefully connecting transferred tissue to establish blood flow as part of genital reconstruction.
Dr. Safir’s experience spans complex primary surgery, staged reconstruction, and revision care. When appropriate, Dr. Safir may combine multiple elements of phalloplasty into a single procedure, reducing the number of separate operations and recovery periods while supporting a safe, well-considered result.
Metoidioplasty
Dr. Safir brings extensive experience to metoidioplasty, especially for patients who need more customization than a standard surgical pathway can offer. He sees metoidioplasty as its own meaningful surgical option for patients whose embodiment goals do not call for phalloplasty, who prefer a less involved operation, or who want a more measured surgical path.
During his patient consultations, Dr. Safir helps patients clarify what they want this procedure to accomplish, then adapts the operation to support their desired outcome as safely and effectively as possible.
Vaginoplasty
Dr. Safir’s experience in labial reconstruction spans more than 25 years. He has adapted this background to gender-affirming vaginoplasty, vulvoplasty, and labiaplasty.
His approach brings reconstructive urology and aesthetic judgment into the same surgical conversation. That means evaluating how tissue will heal, how urinary anatomy may be affected, and how labial detail, proportion, and comfort can contribute to the final result.
Urethroplasty and Urinary Reconstruction
Urethroplasty draws directly on Dr. Safir’s reconstructive urology training, as it requires rebuilding the urinary channel, often after prior surgery or healing complications. When the urethra is affected by these changes, it may narrow, leak, form an opening, or function unpredictably.
Dr. Safir specializes in repairing urethral problems, including complications after gender-affirming bottom surgery. He focuses on restoring a functional urinary channel in tissue that may already be scarred, surgically altered, or part of a larger revision plan.
Surgical Care With Heart and Hands
Dr. Safir describes his work as a mix of “heart and hands.” For him, that means bringing technical skill to the operating room and personal attention to the conversations that happen before and after surgery.
In a field where patients may spend months or years researching their options, these discussions matter. Dr. Safir takes time to understand what each patient is hoping for, what they are worried about, and what they need to know before making a decision. This clarity helps patients place trust not only in the surgical plan, but in the person who will carry it out.
Leadership in Reconstructive Urology
Dr. Safir’s leadership in urology includes a progression of elected roles with the Los Angeles Urological Society, where he served as secretary in 2011, vice president in 2012, and president from 2013 to 2015. These peer-elected positions speak to Dr. Safir’s standing within the urology community.
His career has also included faculty appointments at UCLA, UCSF, and New York Medical College, as well as hospital leadership as chairman of the Department of Surgery at West Hills Hospital and Medical Center. Through peer review and surgical quality committees, he has contributed to the standards that surgeons rely on to support safe, responsible patient care.
Dr. Safir remains active in the American Urological Association and is a member of the World Professional Association for Transgender Health (WPATH), connecting his reconstructive urology background with his work in gender-affirming care.
Selected Honors and Recognition
Throughout his career, Dr. Safir has been recognized for his surgical skill, leadership, academic achievement, and attentive patient care.
- Surgeon of Excellence — Surgical Review Corporation, 2019–2022: Recognition associated with surgical quality, safety standards, and consistent outcomes in surgical care.
- President, Los Angeles Urological Society, 2013–2015: Elected leadership for one of Southern California’s major professional organizations for urologists. Dr. Safir also previously served as the society’s secretary and vice president.
- Dr. Susan Pearlman Award — Northwestern Women’s Physicians Association: Awarded to one graduating resident across all specialties at Northwestern Memorial Hospital for academic excellence, leadership, and compassion for patients.
- Pfizer Scholars in Urology Award: Recognition for leadership, innovation, and outstanding achievement during Dr. Safir’s urology training at Northwestern University Medical School.
- Medical School Research Fellowship — Memorial Sloan Kettering Cancer Center: Research fellowship experience at one of the nation’s leading cancer centers.
Featured Publications
Dr. Safir’s publications focus on the practical challenges at the center of reconstructive urology and gender-affirming surgery: repairing complex anatomy, improving function, managing complications, and refining outcomes.
- Optimization of Second Stage Metoidioplasty — Urology, 2021
- Caring for Transgender Patients: Complications of Gender-Affirming Genital Surgeries — Annals of Emergency Medicine, 2021
- Established and Experimental Techniques to Improve Phalloplasty Outcomes: How to Optimize a Hypercomplex Surgery — Plastic and Reconstructive Surgery Global Open, 2021
- Penile Prosthesis Placement Using an Optimized Method by a Dedicated Transgender Surgery Unit: A Slow Decrease in High Complication Rates — Journal of Urology, 2021
- Overcoming Incontinence: A Woman’s Guide to Treatment — Addicus Books, 2008
- Voiding Function and Dysfunction — chapter in Oxford Textbook of Surgery, 2000
- Validation of the American Association for the Surgery of Trauma Organ Injury Severity Scale for the Kidney — Journal of Trauma, 2000
- Diagnosis and Management of Trauma to the Kidney — Current Opinion in Urology, 1999
- Genitourinary Trauma — chapter in Comprehensive Urology, 1999
Explore more of Dr. Safir’s research contributions and related publications on our Research page.
Beyond the Operating Room
Outside the operating room, Dr. Safir enjoys chess, watchmaking, and time at home with his family and their two Labrador retrievers.
Request a Consultation
With Dr. Safir
To meet with Dr. Safir, request an in-person or virtual consultation using the online form or call Align Surgical Associates at (415) 530-5335. Dr. Safir offers gender-affirming bottom surgery, including complex revision surgery, for patients at our San Francisco and Los Angeles offices.