Keywords
Quality of Life
Sexual Function
Pelvic Floor
gender affirming surgery
Categories
How to Cite
Abstract
Introduction: gender-affirming genital surgery in transgender women can improve their quality of life and sexual function, despite the pelvic risks involved. The increased demand for and access to this surgical intervention highlights the need for comprehensive healthcare.
Objective: to establish the impact of gender-affirming genital surgery on the pelvic health, sexual function, and quality of life of transgender women between 2014 and 2024.
Methodology: a qualitative methodology was used, employing a documentary approach with hermeneutic analysis and scoping review. Databases searched: PubMed, Scopus, Web of Science, and EBSCOhost.
Results: genital reconstruction with tissue viability, preservation of erogenous sensitivity, and a reduction in surgical complications were observed, reflecting the technical efficacy of the surgery.
Conclusion: genital adjustment surgery has a positive impact on sexual satisfaction and body identity perception, as well as an improvement in urinary dynamics and a reduction in pelvic discomfort, resulting in an increase in quality of life manifested by psychological well-being, self-esteem, reduction of gender dysphoria and affective relationships.
References
1. Silva J, Torres L, Bravo-Balado A, Puerto A, Urazán J, Cardozo A. Revisión del estado actual de la cirugía de reasignación genital en pacientes con disforia de género enfocada en el contexto colombiano. RUC. 2018;28(3).
2. Coleman E, Radix A, Bouman W, Brown G, de Vries A, Deutsch M, et al. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. Int J TRANSGENDER Health. 19 de agosto de 2022;23:S1-258.
3. Weinforth G, Fakin R, Giovanoli P, Nuñez D. Quality of Life Following Male-To-Female Sex Reassignment Surgery. Dtsch ARZTEBLATT Int. 12 de abril de 2019;116(15):253-+.
4. Kummaraka U, Oonarom A, Manojai N, Maneeton B, Maneeton N, Chiawkhun P, et al. Effects of Gender Affirming Surgery on the Quality of Life of Transgender Women in Chiang Mai Province, Thailand. J Sex Marital Ther. 2023;49(5):472-83.
5. LeBreton M, Courtois F, Journel N, Beaulieu-Prévost D, Bélanger M, Ruffion A, et al. Genital Sensory Detection Thresholds and Patient Satisfaction With Vaginoplasty in Male-to-Female Transgender Women. J Sex Med. febrero de 2017;14(2):274-81.
6. Canale D, Molinaro A, Marcocci C, Morelli G, Matteucci V, Mollaioli D, et al. Genital Sensitivity and Perceived Orgasmic Intensity in Transgender Women With Gender Dysphoria After Gender-Affirming Surgery: A Pilot Study Comparing Pelvic Floor Evoked Somatosensory Potentials and Patient Subjective Experience. J Sex Med. 1 de septiembre de 2022;19(9):1479-87.
7. Jardim L, Cerentini T, Lobato M, Costa A, da Silva D, Schwarz K, et al. Sexual Function and Quality of Life in Brazilian Transgender Women Following Gender-Affirming Surgery: A Cross-Sectional Study. Int J Environ Res Public Health. diciembre de 2022;19(23).
8. Tran S, Guillot-Tantay C, Sabbagh P, Vidart A, Bosset PO, Lebret T, et al. Systematic Review of Neovaginal Prolapse After Vaginoplasty in Trans Women. Eur Urol Open Sci. 2024;66:101-11.
9. Dominoni M, Scatigno A, Pasquali M, Bergante C, Gariboldi F, Gardella B. Pelvic floor and sexual dysfunctions after genital gender-affirming surgery: a systematic review and meta-analysis. J Sex Med. 2025;22(1):184-95.
10. Kitic A, Pozzo V, Kitic N, Atlan M, Rausky J. Impact of vaginoplasty on sexual health and satisfaction in transgender women. J Sex Med. 1 de marzo de 2025;22(3):536-42.
11. Wiepjes C, Nota N, de Blok C, Klaver M, de Vries A, Wensing-Kruger S, et al. The Amsterdam Cohort of Gender Dysphoria Study (1972–2015): Trends in Prevalence, Treatment, and Regrets. J Sex Med. 2018;15(4):582-90.
12. Abboud M de T, da Silva GVM, Gorgen ARH, Tavares PM, Martins FE, Rosito TE. Evaluation of the surgical and functional outcomes of secondary vaginoplasties with free skin mesh graft in patients following transfeminine genital reconstructive surgery. Transl Androl Urol. septiembre de 2022;11(9):1245-51.
13. Ministerio de Desarrollo Social y Familia. Orientación Sexual e Identidad de Género. Encuesta Casen 2022. 2023; Disponible en: https://observatorio.ministeriodesarrollosocial.gob.cl/storage/docs/casen/2022/Resultados_Identidad_Genero_Orientacion_Sexual_Casen_2022.pdf
14. Jiang DDM, Gallagher SP, Burchill LP, Berli JM, Dugi DIM FACS, Jiang DD, et al. Implementation of a Pelvic Floor Physical Therapy Program for Transgender Women Undergoing Gender-Affirming Vaginoplasty. Obstet Gynecol. 1 de mayo de 2019;133(5):1003-11.
15. Zapata A, Muena C, Quiroz S, Alvarado J, Leppes F, Villalón J, et al. Perception of transgender health care among physicians in northern Chile. Rev Chil Obstet Ginecol. 2021;86(1):61-7.
16. Chaovanalikit T, Wirairat K, Sriswadpong P. Quality of Life, Self-Esteem, and Depression Among Thai Transgender Women Before and After Male-to-Female Gender Confirmation Surgery: A Prospective Cohort Observational Study. Sex Med. agosto de 2022;10(4).
17. Hess J, Rossi Neto R, Panic L, Rübben H, Senf W. Satisfaction with male-to-female gender reassignment surgery. Dtsch Arzteblatt Int. 21 de noviembre de 2014;111(47):795-801.
18. Loree J, Burke M, Rippe B, Clarke S, Moore S, Loree T. Transfeminine Gender Confirmation Surgery with Penile Inversion Vaginoplasty: An Initial Experience. Plast Reconstr Surg-Glob OPEN. mayo de 2020;8(5).
19. Papadopulos N, Lellé J, Zavlin D, Herschbach P, Henrich G, Kovacs L, et al. Psychological Pathologies and Sexual Orientation in Transgender Women Undergoing Gender Confirming Treatment. Ann Plast Surg. 2020;84(3):312-6.
20. van de Grift TC, Elaut E, Cerwenka SC, Cohen-Kettenis PT, Kreukels BPC. Surgical Satisfaction, Quality of Life, and Their Association After Gender-Affirming Surgery: A Follow-up Study. J Sex Marital Ther. 17 de febrero de 2018;44(2):138-48.
21. Pavanello Decaro S, Van Gils S, Van Hoorde B, Baetens K, Heylens G, Elaut E. It Might Take Time: A Study on the Evolution of Quality of Life in Individuals With Gender Incongruence During Gender-Affirming Care. J Sex Med. 1 de diciembre de 2021;18(12):2045-55.
22. Zavlin D, Wassersug R, Chegireddy V, Schaff J, Papadopulos N. Age-Related Differences for Male-to-Female Transgender Patients Undergoing Gender-Affirming Surgery. Sex Med. marzo de 2019;7(1):86-93.
23. Duflot T, Morel-Journel N, Jurek L, Plainard X, Delporte G, Carnicelli D, et al. Function, Satisfaction, and Sexual Activity of Trans Women After Vulvovaginoplasty: Results of a Multicenter Study. Transgender Health. 2025;10(2):185-92.
24. van der Meulen I, Bungener S, van der Miesen A, Hannema S, Kreukels B, Steensma T, et al. Timing of puberty suppression in transgender adolescents and sexual functioning after vaginoplasty. J Sex Med. 2025;22(1):196-204.
25. Wenk M, Rademacher N, Liedl B, Grüne B, Meister B. Post-surgical outcomes in transgender women: a prospective analysis of sexual function and health-related quality of life. World J Urol. 2025;43(1):529.
26. Hess J, Henkel A, Bohr J, Rehme C, Panic A, Panic L, et al. Sexuality after Male-to-Female Gender Affirmation Surgery. BioMed Res Int. 27 de mayo de 2018;2018:1-7.
27. Mokken S, Mullender M, Fritschy I, Özer M, Bouman M, Veen K, et al. Motivations and expectations for feminizing genital gender-affirming surgery: a qualitative exploration of perspectives from trans feminine individuals and health care professionals. Int J Transgender Health. 2025;1-14.
28. Bungener SL, de Vries ALC, Popma A, Steensma TD. Sexual Experiences of Young Transgender Persons During and After Gender-Affirmative Treatment. Pediatrics. diciembre de 2020;146(6):e20191411.
29. Bertolotto M, Liguori G, Bucci S, Iannelli M, Vedovo F, Pavan N, et al. MR imaging in patients with male-to-female sex reassignment surgery: postoperative anatomy and complications. Br J Radiol. 2017;90(1072).
30. Maurer V, Howaldt M, Feldmann I, Ludwig T, Vetterlein M, Gild P, et al. Penile Flap Inversion Vaginoplasty in Transgender Women: Contemporary Morbidity and Learning-Curve Analysis From a High-Volume Reconstructive Center. Front Surg. 23 de febrero de 2022;9.
31. Bustos SS, Bustos VP, Mascaro T, Ciudad P, Forte AJ, Del Corral G, et al. Complications and patient-reported outcomes in transgender women undergoing vaginoplasty: a systematic review and updated meta-analysis. Plast Reconstr Surg Glob Open. 2021;9:e3510
32. Bucci S, Mazzon G, Liguori G, Napoli R, Pavan N, Bormioli S, et al. Neovaginal Prolapse in Male-to-Female Transsexuals: An 18-Year-Long Experience. BIOMED Res Int. 2014;2014.
33. Cardoso da Silva D, Schwarz K, Fontanari AMV, Costa AB, Massuda R, Henriques AA, et al. WHOQOL-100 Before and After Sex Reassignment Surgery in Brazilian Male-to-Female Transsexual Individuals. J Sex Med. 1 de junio de 2016;13(6):988-93.
34. Simbar M, Nazarpour S, Mirzababaie M, Emam Hadi MA, Ramezani Tehrani F, Alavi Majd H. Quality of Life and Body Image of Individuals with Gender Dysphoria. J Sex Marital Ther. 1 de enero de 2018;44(6):523-32.
35. Fallahtafti E, Nasehi M, Rasuli R, Farhud D, Pourebrahim T, Zareeeimahmoodabadi H. Happiness and Mental Health in Pre-Operative and Post-Operative Transsexual People. Iran J PUBLIC Health. diciembre de 2019;48(12):2277-84.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright (c) 1970 Antonia Schifferli Quinteros, Carla Forteza Gallardo, Luciana Jara Pozas, Bárbara Urrea Cárdenas, Carmen Keim Soto, Maria Rehbein Elgueta, Alejandro Hernández-Escobar