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Sexual Function Outcomes Following Gender-Affirming Vaginoplasty: a Literature Review

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Abstract

Purpose of Review

Gender-affirming vaginoplasty is associated with a high degree of patient satisfaction; however, transgender and gender diverse individuals may face significant challenges regarding sexual dysfunction postoperatively. Sexual function is complex and multifaceted, and data regarding postoperative sexual function can help guide patient counseling and decision-making.

Recent Findings

While much of the literature on outcomes of gender-affirming vaginoplasty has focused on capacity to achieve orgasm, numerous parameters of sexual function may impact patient satisfaction and quality of life. Patients may experience decrease in sexual desire and arousal following gender-affirming vaginoplasty; however, the impact of dysphoria vs additional psychosocial factors impacting sexuality vs organic sexual dysfunction remains unclear. Correlation of clitoral function with patient satisfaction is complex and not easily determined. Preoperative anorgasmia may predict postoperative anorgasmia; however, preoperative anorgasmia related to gender dysphoria and incongruence may resolve postoperatively.

Summary

While progress has been made in the literature surrounding gender-affirming vaginoplasty, existing limitations may make it difficult to appropriately counsel patients regarding surgical outcomes related to sexual health. Heterogeneity in study methodology and quality limits the ability to make specific recommendations regarding differences in technique, and there remains a significant need for high-quality, validated patient-reported outcome measures regarding sexual function post-gender-affirming vaginoplasty.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Vattikuti Urology Institute, Henry Ford Health, Detroit, MI, USA

    Samantha Wilder, Briar Shannon & Nabeel Shakir

  2. University of Michigan Medical School, Ann Arbor, MI, USA

    Gaines Blasdel

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  1. Samantha Wilder
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  2. Briar Shannon
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  3. Gaines Blasdel
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  4. Nabeel Shakir
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Correspondence to Nabeel Shakir.

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Wilder, S., Shannon, B., Blasdel, G. et al. Sexual Function Outcomes Following Gender-Affirming Vaginoplasty: a Literature Review. Curr Sex Health Rep 15, 301–306 (2023). https://doi.org/10.1007/s11930-023-00377-8

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