Health of Transgender Women: Gynecological, Hormonal, Sexual and Psychological Management

healthtransgenderwomenkapak

GENITAL CORRECTION (VAGINOPLASTY) IN TRANSGENDER WOMEN: TECHNIQUES, COMPLICATIONS

Melih Bestel

İstanbul Esenyurt University, Faculty of Health Sciences, Department of Gynecology and Obstetrics, İstanbul, Türkiye

Bestel M. Genital Correction (Vaginoplasty) in Transgender Women: Techniques, Complications. Balsak D, Aksin Ş, eds. Health of Transgender Women: Gynecological, Hormonal, Sexual and Psychological Management. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.73-83.

ABSTRACT

Transgender people are people who carry a sexual identity different from their birth gender. A trans woman, defined as a man-to-woman, is an individual who was born with a male gender but wants to continue her life with a female sexual identity. These individuals need and receive psychological, hormonal, and surgical support during their gender adjustment process. Following these supports, trans women experience an improvement in their quality of life, with the majority expressing satisfaction. The increasing acceptance of trans individuals in society and the inclusion of gender-affirmation surgeries (GASs) in the medical scope have led to an increase in the number of patients seeking male-tofemale vaginoplasty. Since 1931, surgeons have increasingly performed female-to-male sex reassignment surgeries. Before surgery, transgender women should receive detailed information about their reproductive functions. Transgender women most commonly request genital reconstructive surgery, including vulvovaginoplasty. The aim of the proposed vaginoplasty and reconstruction surgery is to create a vagina and achieve the best possible appearance of the external genitalia.Surgery generally includes removal of the male external genitalia (orchiectomy, penilectomy), positioning of the urethra, reconstruction of the female external genitalia (labia minors-majora, clitoridis), vaginal opening, and creation of the vagina (vaginoplasty). Despite penile inversion vaginoplasty being the gold standard, the patient’s condition may dictate the use of different types of surgery. Treatment of complications that may occur after the operations and long-term patient follow-up are important. This chapter discusses the history of vaginoplasty in transgender women, various surgical techniques, potential complications, and their management.

Keywords: Vaginoplasty; Penile inversion; Transgender; Intestinal vaginoplasty; Peritoneal vaginoplasty; Gender-affirmation surgery

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