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Using a Novel and Validated Survey tool to Analyze Sexual Functioning Following Vaginoplasty in Transgender Individuals

Alyxandra Ramsay , Jo Blankson, Lara Finnerty-Haggerty, Jiaxin Wu, Joshua Safer, John Pang

Abstract

Introduction: In the healthcare setting, transgender patients are often marginalized, face discrimination, and have limited access to high quality gender affirming care such as gender affirming surgery (GAS). [1]. As a result, the available data pertaining to GAS are often based on convenience samples and the majority of published studies in the US are cross-sectional [2]. Transgender people may undergo GAS to align their bodies with their gender identities. There has been little emphasis on the GAS self-evaluated experience. GAS may be associated with improved quality of life in transgender people. Specific Aim: This study aims to analyze the functionality of transgender patients’ genitals following vaginoplasty. Materials and Methods: 306 transgender patients responded to a validated survey for patient reported feminizing gender affirming surgery outcomes. Surveys were given to patients prior to GAS, and then 2 weeks, 6 months, and 12 months postoperatively. Pre and post GAS responses were compared using McNemar and Wilcoxon signed rank tests. Self-identified race/ethnicity was available for all survey participants. All participants voluntarily took same survey by using the same survey platform to eliminate bias. Results: Five questions showed significant improvement between the 2-week and 6-month responses. These questions assessed if respondents had sensation in their clitoris (p= 0.031), the frequency that clitoral stimulation was pleasurable (p= 0.018), the presence of sexual activity in the past 3 months (p<0.001), the ability to have penetrative vaginal intercourse (p= 0.031), and if labial irritation while walking or exercising decreased (p= 0.051). Significant differences were not detected between the 6-month and 12-month responses for any of the survey questions. Conclusion: The results of five different metrics regarding sexual activity and vaginal functioning showed a significant improvement for transgender people following GAS. Findings also similarly demonstrate a high success rate of sexual activity after GAS. These are significant patient reported outcomes using tools validated for the transgender population. Respondent outcomes significantly improved between the 2-week and 6-month time period, but did not differ between the 6-month and 12-month period, suggesting the ideal time to assess the above described patient perceived outcomes with vaginoplasty is 6 months postoperatively.

SH24070  Accepted 24 December 2024

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