More than a year and a half after surgeons at Johns Hopkins Hospital performed a complex genital transplant on a soldier who also lost his legs in a bomb blast in Afghanistan, the man says he has normal functions and is “feeling whole.”

The progress report came Thursday in a letter to the editor of the New England Journal of Medicine from about two dozen doctors, mostly from Johns Hopkins School of Medicine, but also from Cooper University Health Care in Camden, New Jersey, and Duke University School of Medicine in Durham, North Carolina.

The letter says the man has “near-normal erections and the ability to achieve orgasm,” and can urinate “while standing, without straining, frequency, or urgency, with the urine discharged in a strong stream.”

The transplants remain difficult because they require a willing donor who is a match medically as well as in age and skin tone. The family of the donor to the soldier specifically consented, saying in a statement they wanted to support the man for serving his country.