Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 11;10(2):185-192.
doi: 10.1089/trgh.2023.0047. eCollection 2025 Apr.

Function, Satisfaction, and Sexual Activity of Trans Women After Vulvovaginoplasty: Results of a Multicenter Study

Théo Duflot  1 , Nicolas Morel-Journel  1 , Lucie Jurek  2   3 , Xavier Plainard  4 , Gauthier Delporte  5 , Damien Carnicelli  1 , François Marcelli  6 , Paul Neuville  1   3
Affiliations

Function, Satisfaction, and Sexual Activity of Trans Women After Vulvovaginoplasty: Results of a Multicenter Study

Théo Duflot et al. Transgend Health. .

Abstract

Purpose: This study aimed to analyze the functional outcomes after vulvovaginoplasty for trans women with a comprehensive analysis, including sexual function, satisfaction, and esthetic results.

Methods: A prospective, observational, multicenter study of trans women who underwent vulvovaginoplasty between 2007 and 2019 was conducted at three different centers in France. Data collection was achieved through an online questionnaire. Participants were asked to complete a questionnaire that included the Female Sexual Function Index (FSFI), the Female Genital Self-Image Scale (FGSIS), the Body Image Scale (BIS), and nonvalidated questions to explore sexual practices, related orgasm, genital sensitivity, and specific postsurgical satisfaction.

Results: A total of 158 women were included. Highest scores of the FSFI were obtained for the satisfaction domain, lubrication was scored the lowest. Two-thirds (64%, 89/138) of sexually active women had an FSFI score <26.5 (cutoff suggested for sexual dysfunction); the total mean±standard deviation (SD) FSFI score was 21.2±9.5. Self-image was favorable overall; the mean±SD BIS score was 4.5±5.2 and the mean±SD FGSIS score of 22.1±4.3. Masturbation was the most frequent sexual activity and the only one that led to a positive mean orgasm frequency score. The clitoris was the area women most frequently reported as having "sufficient sensitivity" (67.7%).

Conclusion: This multi-institutional study of functional outcomes after vulvovaginoplasty found positive esthetic outcomes and high satisfaction. More than 85% of trans women were sexually active, and sexuality was rich and common despite mixed functional results. These results enlighten the postoperative outcomes and thereby the points to discuss with women considering vulvovaginoplasty.

Keywords: genital gender-affirming surgery; sexuality; trans; vulvovaginoplasty; women.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Coleman E, Radix AE, Bouman WP, et al. . Standards of care for the health of transgender and gender diverse people, Version 8. Int J Transgender Health 2022;23(sup1):S1–S259; doi: 10.1080/26895269.2022.2100644 - DOI - PMC - PubMed
    1. Pariser JJ, Kim N. Transgender vaginoplasty: Techniques and outcomes. Transl Androl Urol 2019;8(3):241–247; doi: 10.21037/tau.2019.06.03 - DOI - PMC - PubMed
    1. Özer M, Toulabi SP, Fisher AD, et al. . ESSM position statement “sexual wellbeing after gender affirming surgery.” Sex Med 2022;10(1):100471; doi: 10.1016/j.esxm.2021.100471 - DOI - PMC - PubMed
    1. Bouman M-B, van der Sluis WB, van Woudenberg Hamstra LE, et al. . Patient-reported esthetic and functional outcomes of primary total laparoscopic intestinal vaginoplasty in transgender women with penoscrotal hypoplasia. J Sex Med 2016;13(9):1438–1444; doi: 10.1016/j.jsxm.2016.06.009 - DOI - PubMed
    1. Buncamper ME, Honselaar JS, Bouman MB, et al. . Aesthetic and functional outcomes of neovaginoplasty using penile skin in male to female transsexuals. J Sex Med 2015;12(7):1626–1634; doi: 10.1111/jsm.12914 - DOI - PubMed

LinkOut - more resources