Gynecological concerns and vaginal practices and exposures among transfeminine individuals who have undergone vaginoplasty

Author:

Hallarn Jason1ORCID,Bauer Greta R12,Potter Emery34,Wilcox Hannah5,Newfeld Jacy67,Krakowsky Yonah389,Ravel Jacques1011,Prodger Jessica L15

Affiliation:

1. Western University Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, , London, ON N6A 3K7 , Canada

2. University of Minnesota Medical School Institute for Sexual and Gender Health, , Minneapolis, MN 55415 , United States

3. Women’s College Research Institute, Women’s College Hospital , Toronto, ON M5G 1N8 , Canada

4. University of Toronto Lawrence S. Bloomberg Faculty of Nursing, , Toronto, ON M5S 1A1 , Canada

5. Western University Department of Microbiology and Immunology, Schulich School of Medicine and Dentistry, , London, ON N6A 3K7 , Canada

6. University of Toronto Department of Ecology and Evolutionary Biology, , Toronto, ON M5S 1A1 , Canada

7. University of Toronto Mississauga Department of Biology, , Mississauga, ON L5L 1C6 , Canada

8. University of Toronto Transition Related Surgery, Department of Surgery, Women’s College Hospital, , Toronto, ON M5G 1N8 , Canada

9. University of Toronto Division of Urology, Department of Surgery, , Toronto, ON M5S 1A1 , Canada

10. University of Maryland School of Medicine Institute for Genome Sciences, , Baltimore, MD 21201 , United States

11. University of Maryland School of Medicine Department of Microbiology and Immunology, , Baltimore, MD 21201 , United States

Abstract

Abstract Background Vaginoplasty is a gender-affirming surgery that is medically necessary for some transfeminine individuals. Little research exists describing vaginal health after the initial recovery from surgery, and evidence-based guidelines for vaginal care practices are unavailable. Aim The study sought to describe self-reported gynecological concerns and vaginal care practices among transfeminine persons who have undergone vaginoplasty. Methods A total of 60 transfeminine participants 18+ years of age, living in Canada, and who had undergone vaginoplasty at least 1 year prior were recruited through social media, community groups, healthcare provider referrals, and study recontact. Participants completed a cross-sectional, online questionnaire detailing demographics, gynecological concerns, and genital practices and exposures. Hierarchical clustering was used to group participants based on behavioral practices and exposures. Associations between clusters and gynecological concerns were assessed. Outcomes Outcomes included self-reported gynecological concerns within the past year, recent vulvar or vaginal symptoms (past 30 days), and behavioral practices/exposures, including douching with varied products and dilating. Results Participants reported a variety of concerns in the past year, including urinary tract infection (13%) and internal hair regrowth (23%). More than half (57%) had experienced at least 1 recent vaginal symptom, most commonly malodor (27%) and vaginal bleeding (21%). Of participants, 48% were dilating weekly and 52% reported douching in the past 30 days. Four distinct clusters of vaginal practices/exposures were identified: limited exposures; dilating, no douching; dilating and douching; and diverse exposures. No significant associations between cluster membership and gynecological concerns were identified, though cluster membership was significantly associated with surgical center (P = .03). Open-text write-ins provided descriptions of symptoms and symptom management strategies. Clinical Implications The results provide insight for clinicians on common patient-reported gynecological concerns and current vaginal care practices and exposures, including symptom management strategies. Strengths and Limitations This was the first study to investigate vaginal health and genital practices/exposures among a community sample of transfeminine individuals. As participants self-enrolled for a detailed survey and swab collection, individuals experiencing concerns were likely overrepresented. Conclusion Transfeminine individuals reported a range of gynecological concerns outside of the surgical healing period. Genital practices/exposures varied across clusters, but no clear associations between clusters and symptoms were identified; instead, practice/exposure clusters were dependent on where the individual underwent vaginoplasty. There is a need for evidence to inform diagnostics, treatments, and vaginal care guidelines to support vaginal health.

Funder

Canadian Institutes of Health Research

Publisher

Oxford University Press (OUP)

Subject

Urology,Reproductive Medicine,Endocrinology,Endocrinology, Diabetes and Metabolism,Psychiatry and Mental health

Reference31 articles.

1. Surgical outcome after penile inversion vaginoplasty: a retrospective study of 475 transgender women;Buncamper;Plast Reconstr Surg,2016

2. Complications of the neovagina in male-to-female transgender surgery: a systematic review and meta-analysis with discussion of management;Dreher;Clin Anat,2018

3. Complications and patient-reported outcomes in transfemale vaginoplasty: an updated systematic review and meta-analysis;Bustos;Plast Reconstr Surg Glob Open,2021

4. Estimating unmet need for OHIP-funded sex reassignment surgeries: a report prepared for the Ministry of Health and Long-Term Care of Ontario;Bauer;Trans Pulse

5. Decision regret after primary hip and knee replacement surgery;Cassidy;J Orthop Sci,2021

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