Introduction Gender-affirming surgery is common for the treatment of gender dysphoria, but its effect on genital sensitivity is not well known. Aims To investigate genital sensory detection thresholds in male-to-female transgender women postoperatively and their relation to psychological well-being and variables of satisfaction. Methods Prospective study on 28 transgender women at least 18 years old operated on at least 3 months before the study by a single surgeon (N.M.J.). Main Outcome Measures Medical complications; sensory detection thresholds for light touch, pressure, and vibration; and questionnaires on general and sexual satisfaction, sexual function, depression, and psychological well-being. Results Sensory detection thresholds ranged from 0.07 to 2.82 g for light touch, with the neck being most sensitive; from 20.23 to 34.64 g for pressure, with similar results for the neck and clitoris; and from 0.0052 to 0.0111 V for vibration, with similar findings for all stimulation points. Satisfaction with the appearance of the labia, vulva, clitoris, and sexual function was good to very good. Frequency of sexual activities increased significantly postoperatively for orogenital stimulation and decreased significantly for frequency of fantasies (t = −4.81; P < .0001). Orgasmic function was reported by 80% of participants. Psychological adjustment was good to very good, with low depression scores. Sexual satisfaction was statistically and positively correlated with vaginal function and depth, clitoral sensation, appearance of the vulva and labia minora, and natural lubrication and negatively correlated with depression scores. Conclusion Gender-affirming surgery yields good results for satisfaction with appearance and function. Genital sensitivity showed the best results with pressure and vibration.

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In order to better serve bisexual women, clinicians and researchers need tools that accurately reflect and capture bisexual women's experiences of stigma and affirmation. These tools are essential as research indicates that bisexual women experience poorer mental health than either heterosexual or lesbian women. Our community-based study developed and psychometrically evaluated the Bisexual Microaggression and Microaffirmation Scales for Women (BMMS-W). We held focus groups and advisory committee meetings with bisexual women to identify common experiences of microaggressions and microaffirmations and drafted over 200 potential survey items. Exploratory factor analysis of data from 382 participants across Canada and the U.S. yielded five microaggression factors (dismissal; mistrust; sexualization; social exclusion; and denial of complexity) and four microaffirmation factors (acceptance; social support; recognition of bisexuality and biphobia; and emotional support). Confirmatory factor analysis of data from a separate sample of 323 participants across Canada and the U.S. tested the model. The development of the BMMS-W responds to calls to examine the distinctiveness of bisexual women's experience and gives mental health service providers and researchers a tool to better understand their experiences.

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