National Health and Medical Research Council early career senior research fellow and clinical psychologist, Monash University, Melbourne, Victoria, Australia.
Aesthet Surg J. 2021 Nov 12;41(12):NP2046-NP2052. doi: 10.1093/asj/sjab272.
Genital-focused body image concerns or negative genital self-image are a common experience across the gender spectrum, including among cisgender and transgender populations. Such concerns can result in lower psychological and sexual well-being. In this article, it is proposed that the development of genital self-image concerns may be partly explained by the theoretical framework of cisgenderism. This theory proposes that there are only 2 genders-men and women-and these are dictated solely by the appearance of the genitals. Any deviation from these 2 categories can result in discrimination, which particularly impacts transgender individuals. An increasing number of cisgender and transgender people are seeking out aesthetic genital procedures to alleviate genital self-image concerns (and gender dysphoria in transgender populations). The growing body of research suggests that cisgender and transgender men and women are relatively satisfied with the results of their genital procedures. However, this research is limited by a lack of standardized and validated patient-reported measures to evaluate surgical outcomes. Furthermore, despite negative genital self-image being a key motivator for surgery, it is often not included as an outcome measure. In this article, recommendations are proposed for conducting higher-quality evaluation studies of aesthetic genital procedures in cisgender and transgender populations. Moreover, future research and clinical directions are suggested to assist transgender men and women who choose not to undergo genital gender-confirming surgery. The vast majority of transgender individuals do not have this surgery and so are in great need of support in managing their gender dysphoria and negative genital self-image.
生殖器官为中心的身体意象问题或负面的生殖器自我意象在性别范围内很常见，包括顺性别和跨性别群体。这些问题会导致心理和性健康水平下降。本文提出，生殖器官自我意象问题的发展可能部分可以用顺性别主义的理论框架来解释。该理论认为，只有两种性别——男性和女性——而且这些性别完全由生殖器的外观决定。任何偏离这两个类别的情况都可能导致歧视，这对跨性别者的影响尤为明显。越来越多的顺性别和跨性别者正在寻求美容生殖器手术来缓解生殖器官自我意象问题（和跨性别群体中的性别焦虑）。越来越多的研究表明，顺性别和跨性别男性和女性对他们的生殖器手术结果相对满意。然而，由于缺乏标准化和有效的患者报告措施来评估手术结果，因此该研究受到限制。此外，尽管负面的生殖器自我意象是手术的主要动机，但它通常不作为评估指标。本文提出了在顺性别和跨性别人群中进行美容生殖器手术的更高质量评估研究的建议。此外，还提出了未来的研究和临床方向，以帮助选择不进行生殖器性别确认手术的跨性别男性和女性。绝大多数跨性别者不进行这种手术，因此他们非常需要支持来管理他们的性别焦虑和负面生殖器自我意象。
