Last Updated on September 25, 2023 by Shabnam Sengupta
Vaginoplasty is a commonly performed gender-affirming surgery for individuals who identify as gender-diverse and experience a mismatch between their gender and genitalia. The aim of this surgical procedure is to create a visually appealing and fully functional vulva and vaginal canal. This allows for receptive intercourse. This preserves erogenous clitoral sensation and ensures a natural urine stream. This article discusses who all are suitable for gender-affirming vaginoplasty, its process and some post-operative instructions.
Who would be the ideal candidate for gender-affirming vaginoplasty?
The World Professional Association for Transgender Health (WPATH) mandates mental fitness evaluations from reputable mental health care providers before deciding whether someone is suitable for vaginoplasty or any gender-affirming surgery (GAS). Prior to surgery, you should be in good health to speed up healing. It is crucial to be in constant touch with your surgical team. The team will evaluate your health and offer advice on how to get better. This would facilitate a safe surgery and a quicker recovery. Avoiding alcohol and smoking, maintaining a healthy weight and BMI, keeping a check on blood sugar levels, and discussing any ongoing medication plans with your surgical team prior to the treatment are all encouraged.
How is the gender-affirming vaginoplasty carried out?
Vaginoplasty is a surgical gender reconstruction procedure. Prior to the procedure, there are evaluations that an individual has to undergo to determine whether they are suitable for gender-affirming vaginoplasty. The procedure involves creating a functional vaginal vault by dissecting the pelvic floor muscles. This would create a space between the rectum and the prostate. Usually, this surgery can be completed in a single day. The primary objective of the surgery is to develop a functional and anatomically consistent vagina. This leads to the reshaping and repositioning of the tissues in the genital area.
Following the removal of the penis, testicles, and scrotum, the surgeon constructs the vaginal canal and external genitalia, including the labia, during surgery. After the removal, they carefully shape and mould the tissues to create the vaginal canal. The surgeon also creates the external genitalia, including the labia, with the goal of achieving a natural and aesthetically pleasing appearance. Sutures are used to close incisions of the surgical site. This promotes healing. Patients then enter a recovery period. During this, they receive postoperative care, including instructions on wound care, pain management, and other aspects of recovery. Ongoing medical care and monitoring may be necessary to ensure the success of the surgery and address any potential complications.
What postoperative instructions should the candidate for gender-affirming vaginoplasty be aware of?
After their surgery, the patient will need to stay in the hospital for about a week. During the first five days, they will need to remain in bed to ensure successful skin graft recovery. A large bandage will cover the surgical site, and a catheter will be inserted into your bladder for urine drainage. Vaginal packing will also be used to promote skin graft healing.
After the doctor’s approval and a thorough evaluation, the healthcare team will remove both the catheter and vaginal packing to ensure proper bladder function. However, it is important to note that about one in five individuals may experience temporary difficulty urinating independently after catheter removal. If that’s the case, a catheter will be reinserted, and you will leave the hospital with it. Removal will take place during your one-week follow-up appointment. It is important to understand that all surgeries come with some level of risk, even with optimal care. Although rare, there can be some serious complications like rectal injuries, rectovaginal fistulae, vaginal stenosis, and the formation of blood clots or haematomas. Therefore, it is advisable to mentally prepare yourself for such possibilities and seek proper medical advice.
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