Penile inversion vaginoplasty demonstrated positive impacts on sexual health, satisfaction, and functional outcomes in transgender women, with 93% of patients reporting they would decide to have the surgery again.
Key Findings
Results
The majority of transgender women reported improved overall sexual life and satisfaction following penile inversion vaginoplasty.
Retrospective study of 56 patients who underwent primary penile skin inversion vaginoplasty
93% of patients answered 'agreed or totally agreed' when asked 'Would you decide to have vaginoplasty again today?'
Sexual health after vaginoplasty was described as 'significantly improved'
Survey included two validated questionnaires (FGSIS and FSFI) and one custom questionnaire
Results
Post-operative self-confidence was rated highly by approximately 70% of patients.
Around 70% (n = 39) of patients rated their post-operative self-confidence greater than 7 out of 10
Self-confidence was assessed as part of the custom questionnaire exploring various aspects of sexual health and satisfaction
The study highlights the importance of vaginoplasty within multidisciplinary gender transition processes
Results
The majority of patients reported the ability to achieve orgasm following vaginoplasty.
82% of patients reported orgasm after vaginoplasty
Clitoral stimulation emerged as the primary method for achieving sexual arousal post-surgery
The main surgical objective included creation of a sensitive clitoris capable of sexual function
Results
Mean scores on validated sexual function and genital self-image questionnaires indicated moderate-to-positive outcomes.
Mean Female Genital Self-Image Scale (FGSIS) score was 22.8
Mean Female Sexual Function Index (FSFI) score was 22.1
Both questionnaires were originally validated in cisgender women, representing a limitation when applied to transgender women
The authors note that further studies will be necessary to provide questionnaires validated in transwomen
Discussion
The study used a retrospective design with patient-reported outcomes, introducing notable methodological limitations.
Limitations include reliance on patient-reported outcomes prone to recall bias
One of the three questionnaires used was custom and non-validated
The two validated questionnaires (FGSIS and FSFI) were originally developed and validated for cisgender women, not transgender women
Sample size was 56 patients
What This Means
This research studied how gender-affirming vaginoplasty — specifically the penile skin inversion technique, which is the current standard approach — affects sexual health and satisfaction in transgender women. Researchers surveyed 56 patients using two established questionnaires (originally designed for cisgender women) and one custom questionnaire covering topics like self-confidence, sexual arousal, and orgasm. The results showed that most patients experienced meaningful improvements in their sexual lives after surgery, with 82% reporting the ability to achieve orgasm and about 70% rating their post-operative self-confidence above 7 out of 10.
One of the strongest indicators of patient satisfaction was that 93% of participants said they would choose to have the surgery again. Clitoral stimulation was identified as the main way patients achieved sexual arousal after surgery, reflecting the surgical goal of creating a functional, sensitive clitoris. The mean scores on the sexual function and genital self-image scales fell in a moderate-to-positive range, suggesting reasonable functional and psychological outcomes overall.
This research suggests that penile inversion vaginoplasty plays a meaningful role in improving sexual wellbeing as part of a broader gender transition process. However, the findings should be interpreted with caution: the study relied on patients' own recollections, which can be imperfect, and the questionnaires used were not originally designed for transgender women. The authors call for the development of survey tools specifically validated for this population to allow more accurate assessment in future research.
Kitic A, Pozzo V, Kitic N, Atlan M, Rausky J. (2025). Impact of vaginoplasty on sexual health and satisfaction in transgender women.. The journal of sexual medicine. https://doi.org/10.1093/jsxmed/qdae194