Vaginoplasty for trans women, the surgical construction of a vagina and labia from penile and scrotal tissue, is a highly effective treatment for gender dysphoria. For decades, numerous large studies have found that vaginoplasty is associated with a significant reduction in gender dysphoria as well as associated psychiatric comorbidities. This wide-ranging body of research includes these findings, among many others:
- A 2015 study of 49 postsurgical trans women in Italy found that vaginoplasty alleviated gender dysphoria, produced improvements in overall quality of life and sexual quality of life, and improved general functioning and social functioning to levels comparable to the wider population (Prunas et al., 2015).
- A 2014 study of 22 trans women who had been treated with puberty blockers followed by vaginoplasty found that their gender dysphoria was alleviated, with improved psychological functioning and general well-being comparable to the overall population (de Vries et al., 2014).
- A 2013 study of 50 trans women in Italy found that those who had received vaginoplasty had reduced levels of body uneasiness compared to those who had not had vaginoplasty (Bandini et al., 2013).
- A 2006 study of 35 postsurgical trans women in Belgium found levels of psychological functioning similar to the general population, as well as a positive change in family and social life (De Cuypere et al., 2006).
- A 2009 study of 163 postsurgical trans women found that after vaginoplasty, 75% had a more satisfying sex life, and 78% were satisfied with the aesthetic appearance of their genitals (Imbimbo et al., 2009).
- A 2009 study of 50 postsurgical trans women found that they showed high levels of satisfaction with their appearance and self-image, as well as normal levels of overall physical and mental health (Weyers et al., 2009).
A recent study in Plastic and Reconstructive Surgery once again affirms the value of vaginoplasty in the treatment of gender dysphoria. In a group of 117 trans women who underwent vaginoplasty performed by the same surgeon (Dr. Thomas Satterwhite) using the same penile inversion method, those who responded to a survey on their surgical outcomes reported very high levels of satisfaction with their results (Massie et al., 2018).
- The vast majority of respondents confirmed that vaginoplasty was the right choice for them. 94% stated that they “would do this operation again”, 94% reported they were happier now than before receiving surgery, and 91% said they would recommend vaginoplasty to a friend.
- A strong majority reported increased comfort with their new sex organs. 94% stated that they feel positively about their genitals, 88% said that they were not embarrassed about their vagina, 93% would be comfortable receiving a genital exam from a healthcare provider, and 80% said they would feel comfortable about a sexual partner seeing their genitals. Overall, 79% said they were satisfied with the appearance of their vagina.
- Most trans women reported improvements in their experience of sex and arousal. 88% reported that they could become sexually aroused, 75% said they were satisfied with the sexual functioning of their vagina, 67% could reach orgasm within six months following surgery, and 72% noted that the quality of orgasm was “better now compared to before”.
- Vaginoplasty was observed to have a strong impact on symptoms of gender dysphoria: 71% of respondents agreed that their dysphoria was now resolved.
These results both confirm past findings as well as giving additional insight into the wide-ranging benefits of vaginoplasty in the lives of trans women. Contrary to public perceptions of vaginoplasty as a destructive process, this procedure has repeatedly been shown to produce substantial improvement in sexual functioning, body image, and overall comfort with appearance and anatomy, addressing the dysphoria these women experience toward their original genitals. As this study and many others have found, vaginoplasty continues to serve as a key tool in the effective treatment of gender dysphoria. ■
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