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(010) Sexual and Gynecologic Experiences in Transgender Women Following Gender Affirming Vaginoplasty

Year: 2025
Type: article
Study design: Observational Study
Abstract: Introduction Transgender and gender diverse individuals (TGDI) who undergo gender affirming vaginoplasty have multiple methods from which to choose. Historically penile inversion vaginoplasty (PIV) is most commonly offered, but many surgeons now perform peritoneal augmented vaginoplasty (PAV). However, limited data exists on gynecologic concerns and satisfaction post-vaginoplasty for either technique. This has led to a lack of standardized post-surgical guidelines and clinical counseling. Objective This study aims to describe gynecological experiences and exposures as well as patient satisfaction post PIV or PAV at a single site institution. Methods Eligible participants for this study were adults who had undergone PIV or PAV at least 3 months prior to enrollment. Participants attended one study visit during which participants completed a questionnaire that asked about sexual practices alone and with partners, number of partners, STI history, dilating, douching, vaginal symptoms, and post surgical complications and satisfaction. Fisher’s exact tests were performed to determine significance between groups. Results 37 TGDI were included with 8 (23%) PIV and 29 (78%) PAV participants. Mean age was 37.9 and mean age at the time of vaginoplasty was 36.8. Mean time since vaginoplasty was 601.5 days. Post surgical outcomes, vaginal practices and experiences, and sexual behaviors and practices were themes analyzed. Post surgically, 74.3% (26 of 35) of all participants were satisfied or very satisfied with the results of their surgery. 14.3% of participants were unsatisfied with the results of their surgery, including 50% (4 of 8) of PIV participants and 3.7% (1 of 27) of PAV participants (p = 0.006). Reoperation for aesthetic or depth concerns was similar between groups and not statistically significant. Vaginal practices did not show statistical significance, but trends were seen with 25% (2 of 8) of PIV participants experiencing discharge and 41% (12 of 29) PAV participants (p = 0.683) as well as 25% (2 of 8) of PIV participants experiencing bleeding and 41% (12 of 29) of PAV participants (p = 0.683). Those who were sexually active included 62.5% (5 of 8) of PIV participants and 75.9% (22 of 29) of PAV participants (p = 0.655). Specific sexual practices did not show statistical significance, but trends included similar use of sex toys (50% [4 of 8] PIV vs 51.7% [15 of 29] PAV; p = 1.00), more condom use in PAV participants (42.86% [9 of 21] PAV, 20% [1 of 5] PIV; p = 0.353), and high use of lubrication in both groups (87.5% [7 of 8] PIV, 96.6% [28 of 29] PAV; p = 0.232). Conclusions Gynecologic experiences, sexual and non sexual, are multifactorial and can be vastly different from one another in the post genital reconstructive time period despite the vaginoplasty method used. More PIV participants were unsatisfied with their results in the postoperative period and this was found to be statistically significant. Reason for dissatisfaction needs to be further explored prior to attributing it to vaginoplasty type. More data and larger cohorts of vaginoplasty types are needed to draw further conclusions in sexual and vaginal practices. Lastly, validated assessment tools for sexual function after vaginoplasty which are being developed currently, will greatly add to this area of research. Disclosure No.
DOI: 10.1093/jsxmed/qdaf068.010
Language: English
Field: Psychology
Open Access status: bronze
OpenAlex ID: W4409811134
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