Our Summary

This research paper is essentially about how sexual function is considered and managed before, during, and after genital gender-affirming surgery - which is a surgery undergone by transgender individuals to alter their physical appearance to match their gender identity. The paper suggests ways to improve sexual function after the surgery. It looks at clinical observations and genital and surgical anatomy to back up the suggested treatment strategies. It also talks about the benefits of offering shallow-depth vaginoplasty, a specific type of surgical procedure, to all patients. Finally, the paper provides specific ways to enhance the recovery of sexual sensation after the surgery.

FAQs

  1. What is the role of sexual function in planning and discussion before genital gender-affirming surgery?
  2. What is shallow-depth vaginoplasty and why is it important to offer it to all patients?
  3. What strategies can be used to maximize and enhance recovery of erogenous sensation after surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about vaginoplasty is to engage in regular gentle dilation exercises as prescribed by the surgeon to maintain the depth and flexibility of the vagina post-surgery. This can help prevent complications such as narrowing or scarring of the vaginal canal. Additionally, it is important to communicate any concerns or changes in sexual function to your healthcare provider so they can provide appropriate guidance and support.

Suitable For

Vaginoplasty is typically recommended for transgender women who are seeking gender-affirming surgery to align their physical appearance with their gender identity. This procedure may be recommended for individuals who have undergone hormone therapy and counseling, and who have a strong desire to have a more feminine genital appearance and function. Additionally, vaginoplasty may be recommended for individuals who experience gender dysphoria related to their genitalia and who desire to have a more authentic and affirming body. It is important for individuals considering vaginoplasty to undergo a thorough evaluation by a qualified healthcare provider to ensure they are appropriate candidates for surgery and to discuss the potential risks and benefits of the procedure.

Timeline

Before vaginoplasty:

  1. Patient undergoes counseling and evaluation with a mental health professional and a gender specialist to determine readiness for surgery.
  2. Patient consults with a surgeon to discuss the procedure, potential risks and benefits, and expectations for outcomes.
  3. Patient may undergo hormone therapy and hair removal in the genital area to prepare for surgery.
  4. Patient may need to stop smoking and make other lifestyle changes to reduce surgical risks.

After vaginoplasty:

  1. Immediately post-surgery, patient will experience pain, swelling, and discomfort in the genital area.
  2. Patient will need to follow a strict post-operative care regimen, including keeping the surgical site clean and dry, and avoiding strenuous activity.
  3. Patient will have follow-up appointments with the surgeon to monitor healing and address any complications.
  4. Patient will gradually resume normal activities and may begin to explore their new genital anatomy.
  5. Patient may experience changes in sexual function and sensation as they heal and adjust to their new body.
  6. Patient may undergo physical therapy or other interventions to improve sexual function and sensation.
  7. Patient may begin to explore sexual activity with a partner, with guidance from healthcare providers as needed.

Overall, the timeline for a patient before and after vaginoplasty can vary depending on individual factors, but the process typically involves careful planning, thorough preparation, and ongoing support from healthcare providers.

What to Ask Your Doctor

  1. Can you explain the different techniques for vaginoplasty and which one would be most suitable for me?
  2. What are the potential risks and complications associated with vaginoplasty?
  3. How long is the recovery period after vaginoplasty and what can I expect during this time?
  4. How soon after surgery can I resume sexual activity?
  5. Will I still be able to experience sexual pleasure and orgasm after vaginoplasty?
  6. Are there any specific postoperative care instructions I should follow to optimize my sexual function?
  7. Are there any additional procedures or treatments that can enhance sexual function after vaginoplasty?
  8. How often will I need follow-up appointments to monitor my progress and address any concerns related to sexual function?
  9. Can you provide referrals to a sex therapist or counselor who specializes in working with transgender individuals undergoing vaginoplasty?
  10. Are there any resources or support groups available for transgender individuals who have undergone vaginoplasty to discuss sexual function and intimacy issues?

Reference

Authors: Garcia MM. Journal: Clin Plast Surg. 2018 Jul;45(3):437-446. doi: 10.1016/j.cps.2018.04.002. PMID: 29908633