Skip to main content

Advertisement

SpringerLink
Log in

The sexual function among transgender women who have undergone gender-affirming surgery using penile skin inversion vaginoplasty in Thailand

  • Original Paper
  • Published:
European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Gender dysphoria is a condition in which there is a discrepancy between gender identity and the birth-assigned sex. Its prevalence is rising worldwide. The primary objective of this study was to evaluate sexual function in transgender women after gender-affirming surgery using penile skin inversion vaginoplasty. The secondary objectives were to evaluate the most affected domain of the FSFI (female sexual function index) and quality of life (QOL) of these participants.

Methods

This was a cross-sectional study. The data was collected from 69 transgender women who have undergone penile skin inversion vaginoplasty ≥ 3 months prior to the study initiation. The participants were requested to fill out two questionnaires, the FSFI and WHOQOL-BREF. Sexual dysfunction was diagnosed in transgender women with FSFI score ≤ 26 that is traditionally classified as sexual dysfunction.

Results

Eighty-two percent (82.61%) of participants reported a total FSFI score of less than 26. The mean total FSFI score was 22.95, with the lowest score in lubrication domain. However, poor quality of life by WHOQOL-BREF was present in only 2.9% of the tested participants.

Conclusions

This study found a significant prevalence of sexual dysfunction by FSFI score in the transgender women who have undergone gender-affirming surgery using penile skin inversion. Quality of life by WHOQOL-BREF score was, however, generally high in this population.

Level of evidence: Level IV, risk/prognostic study

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. American Psychiatric Association. American Psychiatric Association. DSM-5 Task Force, Washington, D.C

    Book  Google Scholar 

  2. Lindqvist EK, Sigurjonsson H, Möllermark C, Rinder J, Farnebo F, Lundgren TK (2017) Quality of life improves early after gender reassignment surgery in transgender women. Eur J Plast Surg 40(3):223–226

    Article  Google Scholar 

  3. Winter S, Diamond M, Green J, Karasic D, Reed T, Whittle S et al (2016) Transgender people: health at the margins of society. Lancet 388(10042):390–400

    Article  Google Scholar 

  4. Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, DeCuypere G, Feldman J et al (2012) Standards of care for the health of transsexual, transgender, and gender-nonconforming people, Version 7. Available from: https://www.wpath.org/publications/soc. Accessed 9 Jan 2021

  5. De Cuypere G, T’Sjoen G, Beerten R, Selvaggi G, De Sutter P, Hoebeke P et al (2005) Sexual and physical health after sex reassignment surgery. Arch Sex Behav 34(6):679–690

    Article  Google Scholar 

  6. Green R (1998) Sexual functioning in post-operative transsexuals: male-to-female and female-to-male. Int J Impot Res 10(Suppl 1):S22–S24

    PubMed  Google Scholar 

  7. Horbach SE, Bouman MB, Smit JM, Özer M, Buncamper ME, Mullender MG (2015) Outcome of vaginoplasty in male-to-female transgenders: a systematic review of surgical techniques. J Sex Med 12(6):1499–1512

    Article  Google Scholar 

  8. Papadopulos NA, Lellé JD, Zavlin D, Herschbach P, Henrich G, Kovacs L et al (2017) Quality of Life and Patient Satisfaction Following Male-to-Female Sex Reassignment Surgery. J Sex Med 14(5):721–730

    Article  Google Scholar 

  9. Papadopulos NA, Zavlin D, Lellé JD, Herschbach P, Henrich G, Kovacs L et al (2017) Combined vaginoplasty technique for male-to-female sex reassignment surgery: operative approach and outcomes. J Plast Reconstr Aesthet Surg 70(10):1483–1492

    Article  Google Scholar 

  10. Buncamper ME, van der Sluis WB, van der Pas RSD, Özer M, Smit JM, Witte BI et al (2016) Surgical outcome after penile inversion vaginoplasty: a retrospective study of 475 transgender women. Plast Reconstr Surg 138(5):999–1007

    Article  CAS  Google Scholar 

  11. Hage JJ, Karim RB, Laub DR Sr (2007) On the origin of pedicled skin inversion vaginoplasty: life and work of Dr Georges Burou of Casablanca. Ann Plast Surg 59(6):723–729

    Article  CAS  Google Scholar 

  12. Buncamper ME, Honselaar JS, Bouman MB, Özer M, Kreukels BP, Mullender MG (2015) Aesthetic and functional outcomes of neovaginoplasty using penile skin in male-to-female transsexuals. J Sex Med 12(7):1626–1634

    Article  Google Scholar 

  13. Park H, Yoon HG (2013) Menopausal symptoms, sexual function, depression, and quality of life in Korean patients with breast cancer receiving chemotherapy. Support Care Cancer 21(9):2499–2507

    Article  Google Scholar 

  14. Tungmunsakulchai R, Chaikittisilpa S, Snabboon T, Panyakhamlerd K, Jaisamrarn U, Taechakraichana N (2015) Effectiveness of a low dose testosterone undecanoate to improve sexual function in postmenopausal women. BMC Womens Health 15:113

    Article  Google Scholar 

  15. Wiegel M, Meston C, Rosen R (2005) The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther 31(1):1–20

    Article  Google Scholar 

  16. Mahatnirunkul S, Tuntipivatanaskul W, Pumpisanchai W (1998) Comparison of the WHOQOL100 and the WHOQOL-BREF (26 items). J Ment Health Thai 5:4–15

    Google Scholar 

  17. Djordjevic ML, Stanojevic DS, Bizic MR (2011) Rectosigmoid vaginoplasty: clinical experience and outcomes in 86 cases. J Sex Med 8(12):3487–3494

    Article  Google Scholar 

  18. Nimitpanya P, Wainipitapong S, Wiwattarangkul T, Suwan A, Nittaya Phanuphak N, Panyakhamlerd K (2021) Evaluation of mental health and satisfaction following transfeminine gender-affirming surgery in Thailand. Transgender health. https://doi.org/10.1089/trgh.2020.0096

  19. Deutsch MB (ed) (2016) Guidelines for the primary and gender-affirming care of transgender and gender nonbinary people, 2nd edn. San Francisco. Available from: transcare.ucsf.edu/guidelines. Accessed 10 Dec 2020

  20. Pfaus JG (2009) Pathways of sexual desire. J Sex Med 6(6):1506–1533

    Article  CAS  Google Scholar 

  21. Holmberg M, Arver S, Dhejne C (2019) Supporting sexuality and improving sexual function in transgender persons. Nat Rev Urol 16(2):121–139

    Article  CAS  Google Scholar 

  22. Renaud C, Byers ES (1997) Sexual and relationship satisfaction in mainland China. J Sex Res 34:399–410

    Article  Google Scholar 

  23. Byers ES (2005) Relationship satisfaction and sexual satisfaction: a longitudinal study of individuals in long-term relationships. J Sex Res 42(2):113–118

    Article  Google Scholar 

  24. Nappi RE, Cucinella L, Martella S, Rossi M, Tiranini L, Martini E (2016) Female sexual dysfunction (FSD): prevalence and impact on quality of life (QoL). Maturitas 94:87–91

    Article  Google Scholar 

Download references

Funding

The authors received funding from the Ratchadapisek Sompoch, Faculty of Medicine, Chulalongkorn University.

Author information

Authors and Affiliations

  1. Departments of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Rd. Pathum Wan, Pathum Wan District, Bangkok, 10330, Thailand

    Pattarapond Thammapiwan, Ammarin Suwan, Krasean Panyakhamlerd & Nimit Taechakraichana

  2. Center of Excellence in Transgender Health, Chulalongkorn University, Bangkok, Thailand

    Ammarin Suwan, Krasean Panyakhamlerd, Poonpissamai Suwajo & Nittaya Phanuphak

  3. Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

    Poonpissamai Suwajo

  4. Institute of HIV Research and Innovation, Bangkok, Thailand

    Nittaya Phanuphak

Authors
  1. Pattarapond Thammapiwan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ammarin Suwan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Krasean Panyakhamlerd
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Poonpissamai Suwajo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nittaya Phanuphak
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nimit Taechakraichana
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ammarin Suwan.

Ethics declarations

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later comparable ethical standards. The Human Investigation Committee (IRB no. 090/61) of Faculty of Medicine, Chulalongkorn University approved this study.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Consent for publication

Patients signed informed consent regarding publishing their data.

Conflict of interest

Pattarapond Thammapiwan, Ammarin Suwan, Krasean Panyakhamlerd, Poonpissamai Suwajo, Nittaya Phanuphak, and Nimit Taechakraichana declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Thammapiwan, P., Suwan, A., Panyakhamlerd, K. et al. The sexual function among transgender women who have undergone gender-affirming surgery using penile skin inversion vaginoplasty in Thailand. Eur J Plast Surg 45, 101–107 (2022). https://doi.org/10.1007/s00238-021-01857-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00238-021-01857-7

Keywords

Search

Navigation