Sexual Function and Sexual Satisfaction Following Gender-Affirming Genital Surgery: A Scoping Review

Abstract

Historically, outcome measures for gender-affirming genital surgery have focused on medical and surgical outcomes, with limited attention to patients’ reports of post-surgical sexual function and sexual satisfaction. The aim of this scoping review was to assess the published literature on patients’ sexual function and sexual satisfaction following gender affirming genital surgery, identifying gaps in the evidence base and potential areas of focus for future research efforts. Our sample included English-language studies published in the past 20 years addressing measures of sexual health, sexual function, and/or sexual well-being for individuals who underwent gender affirming genital surgery. Systematic reviews, meta-analyses, and other forms of reviews were excluded. The final sample consisted of ten articles. All studies addressed sexual function through assessment of ability to orgasm. Overall, transgender women who underwent vaginoplasty and were sexually active post-operatively described improved sexual function after surgery. In one study, transgender men showed moderate improvement of sexual function while another indicated reduced sexual function compared to transgender men treated with hormones only. Prospective research is needed to improve understanding of patients’ values, goals and expectations for sexual function and sexual satisfaction following surgery, and to inform the development of validated outcomes measures.