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

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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.


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.


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.


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

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

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Correspondence to Ammarin Suwan.

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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.

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

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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.

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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).

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