Our Summary

This research paper discusses the history and advancements in a type of gender-affirming surgery that transforms male genitals into female ones. This procedure, commonly referred to as vaginoplasty, is more accurately termed “aidopoiesis” because it involves creating a female genitalia, not improving an already existing one. The paper explains how the techniques used in this surgery have evolved since the 1930s, with significant progress made in Denmark after World War II.

The modern method of turning the penile skin inside out to form a vagina was developed in the 1950s by surgeons in England and Morocco. Further improvements were made in the 1970s, such as creating a clitoris from the tip of the penis and making the vulva look more natural. Some techniques involve using flaps of skin or parts of the intestine, often to fix issues with the inside-out penile skin method.

The paper highlights how individuals like Lili Elbe and Christine Jorgensen, who underwent these surgeries in the early stages, helped to bring awareness and acceptance to these procedures, which were once considered taboo. It also acknowledges the contributions of pioneers like Georges Burou, a gynaecologist in Morocco, who discreetly improved these techniques, thereby improving the well-being of those affirming their gender. The paper concludes by emphasizing the importance of this historical knowledge for current surgeons practicing vaginoplasty.

FAQs

  1. What is the history of vaginoplasty and how has it evolved over the years?
  2. Who were some of the key individuals who brought awareness and acceptance to gender-affirming surgeries like vaginoplasty?
  3. What are some of the modern techniques used in vaginoplasty?

Doctor’s Tip

One helpful tip a doctor might tell a patient about vaginoplasty is to carefully follow all pre-operative and post-operative instructions provided by the surgeon. This can help reduce the risk of complications and ensure optimal healing and outcomes. It’s also important to have realistic expectations about the results of the surgery and to openly communicate any concerns or questions with the medical team. Additionally, attending follow-up appointments and adhering to any prescribed medications or physical therapy exercises can aid in a smooth recovery process.

Suitable For

Patients who are typically recommended vaginoplasty are transgender women who desire to have female genitalia to align with their gender identity. This surgery is often considered a crucial step in their gender affirmation journey, helping them feel more comfortable and confident in their bodies. Additionally, individuals with intersex variations or certain medical conditions may also benefit from vaginoplasty to address issues with their genitalia. It is important for patients to undergo thorough psychological evaluation and counseling before undergoing this surgery to ensure they are mentally prepared for the physical and emotional changes that come with it.

Timeline

Before vaginoplasty:

  1. Patient experiences gender dysphoria and seeks out gender-affirming surgery.
  2. Patient undergoes psychological evaluation and counseling to ensure readiness for surgery.
  3. Patient may undergo hormone therapy to align their physical characteristics with their gender identity.
  4. Patient discusses surgical options with their healthcare provider and decides on vaginoplasty.
  5. Patient undergoes pre-operative medical tests and evaluations to ensure they are a suitable candidate for surgery.

After vaginoplasty:

  1. Patient undergoes vaginoplasty surgery, where the male genitals are transformed into female genitalia.
  2. Patient stays in the hospital for a few days to recover and receive post-operative care.
  3. Patient experiences pain and discomfort during the initial recovery period.
  4. Patient follows a strict post-operative care plan, including wound care and dilation exercises to maintain the new vaginal canal.
  5. Patient attends follow-up appointments with their healthcare provider to monitor healing and address any concerns.
  6. Patient may undergo additional surgeries or procedures to enhance the appearance or function of the new genitalia.
  7. Patient experiences improved mental health and quality of life as they align their physical body with their gender identity.

What to Ask Your Doctor

Questions a patient should ask their doctor about vaginoplasty may include:

  1. What are the risks and potential complications associated with vaginoplasty?
  2. What is the recovery process like after vaginoplasty, and how long does it typically take?
  3. How will vaginoplasty affect my sexual function and sensation?
  4. What are the long-term results and outcomes of vaginoplasty?
  5. What kind of aftercare and follow-up appointments will be necessary after the surgery?
  6. Are there any alternative procedures or treatments that I should consider before deciding on vaginoplasty?
  7. What is the expected cost of vaginoplasty, and will insurance cover any part of the procedure?
  8. How experienced are you in performing vaginoplasty, and what is your success rate with this surgery?
  9. Can you provide me with before and after photos of previous vaginoplasty patients you have treated?
  10. Are there any specific instructions or preparations I need to follow before undergoing vaginoplasty?

Reference

Authors: Bertrand B, Perchenet AS, Casanova D. Journal: Ann Chir Plast Esthet. 2023 Nov;68(5-6):389-396. doi: 10.1016/j.anplas.2023.07.001. Epub 2023 Sep 19. PMID: 37735028