Our Summary

This research paper examines the risk of sexually transmitted infections (STIs) in transgender and gender-diverse individuals who have undergone a specific type of gender affirmation surgery known as vaginoplasty (surgical creation of a vagina). Cases of STIs, including HPV, HSV, HIV, gonorrhea, and chlamydia, have been reported in individuals after this surgery, but these reports are uncommon. The research also discusses the possible link between the composition of the bacteria found in the newly created vagina (the neovaginal microbiota) and a common vaginal infection known as bacterial vaginosis. The paper suggests that by altering this bacterial composition, there may be a potential to reduce the risk of bacterial vaginosis and STIs in these individuals. It also compares the bacterial environment of the newly created vagina to that of a naturally occurring one.

FAQs

  1. What is the risk of sexually transmitted infections (STIs) in individuals who have undergone vaginoplasty?
  2. Is there a potential link between the neovaginal microbiota and bacterial vaginosis?
  3. How does the bacterial environment of a surgically created vagina compare to that of a naturally occurring one?

Doctor’s Tip

A doctor may advise a patient undergoing vaginoplasty to practice safe sex and use barrier methods such as condoms to reduce the risk of sexually transmitted infections. They may also recommend regular check-ups and screenings for STIs to monitor and maintain their sexual health. Additionally, maintaining good hygiene and following post-operative care instructions can help prevent infections and promote healing after surgery. It is important for patients to communicate openly with their healthcare provider about any concerns or symptoms they may experience following vaginoplasty.

Suitable For

Patients who are typically recommended for vaginoplasty are transgender and gender-diverse individuals who desire gender affirmation surgery to align their physical appearance with their gender identity. Vaginoplasty is often recommended for individuals assigned male at birth who identify as female or non-binary and wish to have a vagina constructed.

These patients may have gender dysphoria, a condition where a person’s gender identity does not align with their assigned sex at birth, and may experience distress or discomfort as a result. Vaginoplasty can help alleviate these feelings and improve the individual’s quality of life by allowing them to live more authentically as their true gender.

It is important for individuals considering vaginoplasty to undergo a thorough evaluation by a mental health professional and a medical provider specializing in transgender healthcare to determine if they are good candidates for the surgery. Additionally, patients should be in good overall health and have realistic expectations about the outcomes of the surgery.

Overall, vaginoplasty is a surgical option that can be beneficial for transgender and gender-diverse individuals seeking gender affirmation and improved quality of life.

Timeline

Before vaginoplasty:

  1. Consultation with a gender-affirming surgeon to discuss the procedure and potential risks and benefits.
  2. Psychological evaluation and counseling to assess readiness for surgery.
  3. Hormone therapy to help prepare the body for surgery and enhance feminization.
  4. Pre-operative testing and preparation, including blood work and physical examination.
  5. Surgical procedure to create a vagina using penile and scrotal tissue, with possible use of a skin graft.
  6. Post-operative recovery period, including pain management and wound care.
  7. Follow-up appointments with the surgeon to monitor healing and address any complications.

After vaginoplasty:

  1. Continued hormone therapy to maintain feminization and support healing.
  2. Dilator therapy to prevent vaginal stenosis and maintain vaginal depth and width.
  3. Regular follow-up appointments with the surgeon to monitor healing and address any complications.
  4. Possible complications, such as infection, bleeding, or vaginal prolapse, that may require additional treatment.
  5. Resumption of sexual activity once cleared by the surgeon, with potential risks of STIs and bacterial vaginosis.
  6. Long-term maintenance of the neovagina, including regular dilation and hygiene practices.
  7. Psychological counseling and support to navigate any emotional or psychological changes post-surgery.

Overall, the timeline before and after vaginoplasty involves a comprehensive process of preparation, surgery, recovery, and long-term maintenance to achieve a successful outcome and optimize the patient’s overall well-being.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with vaginoplasty surgery?
  2. How will my sexual function be affected after vaginoplasty?
  3. What is the recovery process like after vaginoplasty surgery?
  4. Will I need to undergo any additional surgeries or procedures in the future?
  5. How often will I need to have follow-up appointments after vaginoplasty?
  6. Are there any specific measures I should take to reduce the risk of STIs or bacterial infections after vaginoplasty?
  7. How can I maintain the health of my neovagina and prevent potential infections?
  8. Are there any specific hygiene practices I should follow after vaginoplasty?
  9. What signs or symptoms should I watch out for that may indicate a problem with my neovagina?
  10. Are there any lifestyle changes I should consider after undergoing vaginoplasty surgery?

Reference

Authors: Werneburg GT, Fascelli M. Journal: Curr Opin Urol. 2024 Sep 1;34(5):323-329. doi: 10.1097/MOU.0000000000001203. Epub 2024 Jun 20. PMID: 38903052