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. 2018 May 27:2018:9037979.
doi: 10.1155/2018/9037979. eCollection 2018.

Sexuality after Male-to-Female Gender Affirmation Surgery

J Hess  1 , A Henkel  1 , J Bohr  2 , C Rehme  1 , A Panic  1 , L Panic  1   3 , R Rossi Neto  1   4 , B Hadaschik  1 , Y Hess  1   2
Affiliations

Sexuality after Male-to-Female Gender Affirmation Surgery

J Hess et al. Biomed Res Int. .

Abstract

Male-to-Female (MtF) gender affirmation surgery (GAS) comprises the creation of a functional and aesthetic perineogenital complex. This study aimed to evaluate the effect of GAS on sexuality. We retrospectively surveyed all 254 MtF transsexual patients who had undergone GAS with penile inversion vaginoplasty at the Department of Urology, University Hospital Essen, Germany, between 2004 and 2010. In total, we received 119 completed questionnaires after a median of 5.05 years since surgery. Of the study participants, 33.7% reported a heterosexual, 37.6% a lesbian, and 22.8% a bisexual orientation related to the self-perceived gender. Of those who had sexual intercourse, 55.8% rated their orgasms to be more intensive than before, with 20.8% who felt no difference. Most patients were satisfied with the sensitivity of the neoclitoris (73.9%) and with the depth of the neovaginal canal (67.1%). The self-estimated pleasure of sexual activity correlated significantly with neoclitoral sensitivity but not with neovaginal depth. There was a significant correlation between the ease with which patients were able to become sexually aroused and their ability to achieve orgasms. In conclusion, orgasms after surgery were experienced more intensely than before in the majority of women in our cohort and neoclitoral sensitivity seems to contribute to enjoyment of sexual activity to a greater extent than neovaginal depth.

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Figures

Figure 1
Figure 1
Sexual orientation related to the self-perceived gender.
Figure 2
Figure 2
Satisfaction with neoclitoral sensitivity.
Figure 3
Figure 3
Satisfaction with neovaginal depth.
Figure 4
Figure 4
Modality as to how orgasms were achieved (multiple answers possible). (a) Absolute number of patients. MB = masturbation; SI = sexual intercourse; OT = other (not further specified); NO = no orgasm; NA = no answer. (b) Modality as percentage of answers.
Figure 5
Figure 5
Patients' general satisfaction with their sex lives. Likert scale ranging from 0 (“very dissatisfied”) to 10 (“very satisfied”).
See this image and copyright information in PMC

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