Most individuals with CAIS reported positive body image and the ability to engage in fulfilling sexual activity, with vaginal lengths largely comparable to the general population.
Vaginal lengths in individuals with CAIS were largely comparable to those reported in the general population.
Sexual function and satisfaction scores in CAIS individuals were within normal ranges for the U.S. female population.
Most individuals with CAIS reported a positive body image.
The study cohort of CAIS individuals was relatively young and diverse in gonadectomy status.
This research suggests that people with complete androgen insensitivity syndrome (CAIS) — a condition where a person is genetically male but is resistant to androgens (male hormones) and typically develops a female appearance — generally have positive sexual health outcomes and body image. The study followed 23 individuals with CAIS, ranging in age from 14 to 65, and found that their vaginal lengths were mostly similar to those seen in the general population, that their sexual function and satisfaction scores fell within normal ranges for U.S. women, and that they reported relatively low levels of body image distress. Notably, most participants did not require interventions such as vaginal dilation or surgery to achieve these outcomes, which has historically been a concern in clinical care for people with CAIS. Only 3 participants were using serial vaginal dilations and 1 had undergone vaginoplasty, suggesting that many individuals with CAIS may not need these procedures to achieve satisfactory vaginal function. This research matters because clinical guidance for people with CAIS has often been based on limited data, and assumptions about poor sexual outcomes may have led to unnecessary medical interventions or overly negative counseling. These findings suggest that clinicians should approach counseling for individuals with CAIS in a more individualized and optimistic way, recognizing that many patients can achieve positive sexual well-being and body image without extensive medical intervention. The study is ongoing (an interim analysis), so future results with a larger sample may provide even more detailed insights.
Lehembre-Shiah E, Adams M, Soliman M, Kaur H, Brookhart C, Das K, et al.. (2026). The Sexual Health and Well-being of Individuals With Complete Androgen Insensitivity Syndrome (CAIS).. Journal of pediatric and adolescent gynecology. https://doi.org/10.1016/j.jpag.2025.10.014