Urethral strictures are not uncommon after microvascular phalloplasty in female-to-male transsexuals, and usually are secondary to technical errors or vascular complications. A case of a female-to-male transsexual with recalcitrant urethral stricture after microvascular phalloplasty is reported. After one unsuccessful attempt at direct repair and a failed grafting procedure, a tubulized island flap from the remnants of the labia minora was successfully used to reconstruct the urethral stenosis. Current options for treatment of urethral stenoses in female-to-male transsexuals are discussed.