The results of vaginoplasty by inversion of penile and scrotal skin in male-to-female transsexuals, in general, are satisfying. Cosmetic and functional considerations dictate the construction of a neoclitoris ventral to the urethral orifice. Embryologically, the glans penis and clitoris are homologues and mutual substitution seems to be the logical approach. In this paper, the long-term results in the first 60 patients using the pedicled sensate neoclitoroplasty according to Brown are presented and discussed. It has proven to be a safe technique that leads to satisfying cosmetic and functional results in nearly all patients. It should be considered state of the art in primary gender-confirming surgery for male-to-female transsexuals.