Sexual health after vaginoplasty: A systematic review

Kloer, Carmen; Parker, Augustus; Blasdel, Gaines; Kaplan, Samantha; Zhao, Lee C.; Bluebond-Langner, Rachel

doi:10.1111/andr.13022

Cited by 23 publications

(18 citation statements)

References 163 publications

(1,420 reference statements)

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“…While complications may occur, most are self-limited or can be treated with minor interventions (Hontscharuk, Alba, Hamidian Jahromi et al., 2021 ). Minor complications include issues such as the formation of granulation tissue, intravaginal hair growth, delayed wound healing or wound disruption (or both), aesthetic concerns, and introital stenosis (Ferrando, 2020 ; Kloer et al., 2021 ). While these complications are usually self-limited, they may impact patient well-being after surgery.…”

Section: Chapter 13 Surgery and Postoperative Carementioning

confidence: 99%

“…Scientific attention to the sexual experiences and behaviors of TGD people has grown in recent years (Gieles et al., 2022 ; Holmberg et al., 2019 ; Klein & Gorzalka, 2009 ; Kloer et al., 2021 ; Mattawanon et al., 2021 ; Stephenson et al., 2017 ; Tirapegui et al., 2020 ; Thurston & Allan, 2018 ). This expansion within the literature reflects a sex-positive framework (Harden, 2014 ), a framework that recognizes both the positive aspects such as sexual pleasure (Laan et al., 2021 ) and potential risks associated with sexuality (Goldhammer et al., 2022 ; Mujugira et al., 2021 ).…”

Section: Chapter 17 Sexual Healthmentioning

confidence: 99%

“…Transition-related care can affect sexual function, pleasure, and satisfaction, both in positive and negative ways (Holmberg et al., 2018; Kerckhof et al., 2019 ; Thurston & Allan, 2018 ; Tirapegui et al., 2020 ). On the positive side, gender-affirming care can help TGD people improve their sexual functioning and increase their sexual pleasure and satisfaction (Kloer et al., 2021 ; Özer et al., 2022 ; T'Sjoen et al., 2020). On the negative side, however, data indicate problematic sexual health outcomes due to hormonal and surgical treatments (Holmberg et al., 2018; Kerckhof et al., 2019 , Stephenson et al., 2017 ; Weyers et al., 2009 ).…”

Section: Chapter 17 Sexual Healthmentioning

confidence: 99%

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Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

Coleman

Radix

Bouman

et al. 2022

International Journal of Transgender Health

806

492

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Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for t...

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Section: Chapter 13 Surgery and Postoperative Carementioning

confidence: 99%

Section: Chapter 17 Sexual Healthmentioning

confidence: 99%

Section: Chapter 17 Sexual Healthmentioning

confidence: 99%

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Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

Coleman

Radix

Bouman

et al. 2022

International Journal of Transgender Health

806

492

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“…Complication-and outcome-reports are sparse and reviews compare at best two techniques 19,20 and lack meta-analyses. [21][22][23] Initially, male pronounces were applied and surgery aimed for genitalia removal without new partner awareness of previous sex, but today female identity is recognized, with emphasis on aesthetics and functionality. The neovagina requires to be hairless, moist and minimally 11 cm deep and 3 cm wide, with labia minora, majora and a sensate clitoris.…”

Section: Vaginoplasty -Gender Dysphoriamentioning

confidence: 99%

Vaginoplasty for Gender Dysphoria and Mayer-Rokitansky-Küster-Hauser Syndrome: A Systematic Review and Meta-analysis

Sueters

Groenman

Bouman

et al. 2022

Preprint

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BACKGROUND: About 8,800-34,200 Gender Dysphoria (GD)- and 39,000-650,800 Mayer-Rokitansky-Küster-Hauser (MRKH)-patients undergo vaginoplasty annually. Various procedures are available, but comparisons are lacking. OBJECTIVES: To highlight information gaps, weaknesses and strengths of vaginoplasty techniques, to aid well-informed decision making by patients and healthcare professionals. SEARCH STRATEGY: A systematic search in Medline, EMBASE, Web of Science and Scopus until October 6, 2022, by PICO method and PROSPERO registration. SELECTION CRITERIA: Original retrospective studies on complete neovaginal creation in adult GD- and MRKH-patients and discussing anatomy, Quality of Life (QoL), satisfaction, sexual function, complications or complaints. DATA COLLECTION AND ANALYSIS: The 95% confidence intervals were calculated with DerSimonian and Laird random-effects. Methodological quality and potential bias were assessed. MAIN RESULTS: In total, 35 GD- and 16 MRKH-studies were eligible. Vagina length was 11.6 and 9.5 cm, respectively. In GD-patients, Hemorrhage (6%), prolapse (1%), gastrointestinal complications (1%), revisions (26%), pain (6%), regret (1%), fecal- (11%) and urinary issues (17%) were reported. Necrosis, stenosis, dyspareunia and revisions decreased, while duration increased with higher graft quantity. Intestinal-vaginoplasty reported 100% sensation. MRKH-patients reported more necrosis (17%) [McIndoe] and average satisfaction with sexual function (91%) and vaginal discharge (32%). They were more sexually active (86%) and had 100% anatomical satisfaction. Only Intestinal-vaginoplasty reported overall dissatisfaction. CONCLUSIONS: For GD- and MRKH-patients, multiple safe vaginoplasty techniques demonstrated acceptable outcomes, with significantly improved QoL and self-image. However, standardized validation tools are needed for well-informed decision-making. Direct technique comparisons per patient-cohort and exploration of tissue-engineering methods are critical for future surgical advancements.

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“…Kloer et al. conducted a systematic review of sexual health following vaginoplasty 12 . They found median rates of 81% for general sexual satisfaction and 80% for ability to achieve orgasm postoperatively.…”

mentioning

confidence: 99%

The growing and interdisciplinary field of transgender health

Irwig

2021

Andrology

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Sexual health after vaginoplasty: A systematic review

Cited by 23 publications

References 163 publications

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

Vaginoplasty for Gender Dysphoria and Mayer-Rokitansky-Küster-Hauser Syndrome: A Systematic Review and Meta-analysis

The growing and interdisciplinary field of transgender health

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