Table of ContentsView AllTable of ContentsBenefits of SurgeryPossible Future SurgeriesLifestyle AdjustmentsNext in Vaginoplasty GuideVaginoplasty: Everything You Need to Know
Table of ContentsView All
View All
Table of Contents
Benefits of Surgery
Possible Future Surgeries
Lifestyle Adjustments
Next in Vaginoplasty Guide
Vaginoplasty—also called transfeminine bottom surgery—is a gender-affirming surgery that entails creating a new vagina (called a “neovagina”), usually from the inverted skin and tissue of the penis.
Most patients are satisfied with the outcome of the surgery, feeling more physically and emotionally comfortable with their bodies.
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For most patients, there are lifelong psychological and physical benefits to undergoing a vaginoplasty. While it is most often a gender-affirming procedure, vaginoplasty is also less commonly done as part of vaginal reconstructive surgery for cis-gendered women.
Psychologically, after a vaginoplasty, patients usually feel more affirmed in their gender as a female, experience higher self-esteem, and have decreased stress related to their bodies.
In one study of 49 transgender women who underwent vaginoplasty using the penile skin inversion technique, the functionality and cosmetic appearance of their neovagina were given an average score of 8 out of 10 (10 being the highest satisfaction).
In another study of 117 patients who underwent penile inversion vaginoplasty, 94% of the patients reported “feeling positive about their genitals” and “would do this operation again.” Seventy-one percent of patients reported resolution of theirgender dysphoria.
Physically, patients often report an increase in sexual functioning and fulfillment after a vaginoplasty. With a new inner and outer vagina, patients may undergo vaginal intercourse and experience an orgasm through stimulation of the clitoris, which is made from the head of the penis.
After a vaginoplasty, it’s important to follow up with your surgeon for regular preventive care.Your surgeon will perform an exam of the vulva, perianal region, and neovagina. They will monitor for potential long-term complications of a vaginoplasty (which may vary based on the surgical technique used).
Some of these complications include:
Cancer Screening
Anal cancerscreening may also be considered in HIV-positive transgender women, considering infection with HIV is linked to a 30-fold increased risk of developing anal cancer.
Your provider may perform a speculum examination to evaluate the skin of the inverted penis to look forpre-cancerous lesions of the penis(called penile intraepithelial neoplasia). It is reasonable to have a regular visual pelvic exam to look for growths/cancers that could typically occur on the skin of the penis. Alternatively, if the less common procedure using the bowel is used to create the neovagina, colon cancer screening would be recommended as applicable.
Although there have been cases of HPV-related cancers in neovaginas, there is limited data on cancer screening for transgender women with neovaginas and there is no recommendation for routinehuman papillomavirus (HPV)testing.
It’s important to discussprostate cancerscreening with your healthcare provider. The decision to perform screening should be based on the same guidelines used for non-transgender men.The only difference is that in a transgender woman who has undergone vaginoplasty, the upper limit of normal for theprostate-specific antigen (PSA) testshould be reduced to 1.0 nanograms per milliliter (ng/mL).
While a vaginoplasty is a relatively safe operation, future surgical procedures may be needed if certain complications arise.
These surgeries may involve:
Moreover, a vaginoplasty is one step in the journey of surgically transitioning from a male to a female. Besides a vaginoplasty, many patients will choose to undergo additional surgeries, such asbreast augmentationandfacial feminization surgery.
After your vaginoplasty, you will need to engage in various lifestyle practices.
Vaginal Dilation
Vaginal dilation is essential for maintaining the girth and depth of the newly created vaginal canal. Your surgeon will provide you with the dilators, as well as a precise dilation schedule to follow.
A typical schedule may include:
Hygiene Practices
After a vaginoplasty, it’s important to be extra diligent about keeping your genital area clean and dry.
Some healthy hygiene habits to adopt include:
Infection Monitoring
Because of the shortening of the urethra,urinary tract infections (UTIs)are more common after a vaginoplasty. Call your healthcare provider if you are experiencing UTI symptoms, such as:
Due to increased vaginal moisture from dilating and/or from antibiotic use after surgery,vaginal yeast infectionsmay also occur after a vaginoplasty.
Call your healthcare provider if you are experiencing these possible symptoms of a yeast infection:
Pelvic Floor Physical Therapy
After a vaginoplasty, patients are enrolled in apelvic floor physical therapy program. Besides strengthening your pelvic muscles, a physical therapist can help with issues like painful or insufficient vaginal dilations, as well as urinary leakage after surgery (if persistent).
A Word From Verywell
No doubt, after a vaginoplasty, most patients are satisfied with the outcome, both functionally and aesthetically. Nevertheless, a vaginoplasty is a major surgery—it can be costly and requires an extensive recovery and lifelong commitment to vaginal dilation.
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Kaiser Permanente Medical Group.Vaginoplasty and feminizing genital surgical options
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Hess J et al.Sexuality after male-to-female gender affirmation surgery.Biomed Res Int. 2018; 2018: 9037979. doi:10.1155/2018/9037979
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Bollo J, Balla A, Luppi CR, Martinez C, Quaresima S, Targarona EM.HPV-related squamous cell carcinoma in a neovagina after male-to-female gender confirmation surgery.Int J STD AIDS. 2018;29(3):306-308. doi:10.1177/0956462417728856
Wesp L.Prostate and testicular cancer considerations in transgender women. UCSF Transgender Care. June 2016.
University of Utah.Gender affirmation surgery.
Meltzer T.Vaginoplasty procedures, complications and aftercare. UCSF. June 2016.
Kaiser Permanente Medical Group.Recovering from vaginoplasty and other feminizing genital surgeries. 2020.
Jiang DD, Gallagher S, Burchill L, Berli J, Dugi D.Implementation of a pelvic floor physical therapy program for transgender women undergoing gender-affirming vaginoplasty.Obstet Gynecol.2019;133(5):1003-1011. doi:10.1097/AOG.0000000000003236
van der Skuis WB et al.Long-term follow-up of transgender women after secondary intestinal vaginoplasty.J Sex Med.2016 Apr;13(4):702-10. doi:10.1016/j.jsxm.2016.01.008
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