Wang Guanhuier, Chang Xu, Yang Xin, Zhao Runlei, Qian Jiaying, Liu Ye, Xing Qiannan, Pan Bailin
Department of Plastic Surgery, Peking University 3rd Hospital, Beijing, 100191, China.
Aesthetic Plast Surg. 2025 Jan 8. doi: 10.1007/s00266-024-04628-4.
Gender-affirming surgery (GAS) for transgender females developed relatively late and limited in China due to some reasons. To introduce GAS surgical experiences for Chinese transgender females is necessary.
To report surgical choices and experience including clitoral/urethral reconstruction, vaginoplasty, and vulvoplasty, and their outcomes.
A single-center, retrospective case series was conducted among transgender females who underwent GAS between September 2018 and March 2023. Surgical outcomes were evaluated including short-term and long-term complications. Scar-Q Scale, Female Sexual Function Index (FSFI), Amsterdam Hyperactive Pelvic Floor Scale-Women (AHPFS-W), and Female Genital Self-Imaging Scale (FGSIS) were carried out for outcome evaluation.
Thirteen transgender females underwent GAS. Among them, 7 patients underwent sigmoid colon vaginoplasty, 3 patients underwent zero-depth vaginoplasty (ZDV), and 3 patients underwent vaginoplasty using skin flap (penile or scrotum). Postoperative follow-up showed that for sigmoid colon neo-vagina, vaginal length can reach 10-15 cm, with a width of about 2 fingers. For skin flap neo-vagina, the long-term vaginal length can maintain at around 8-10 cm, with a width of about 2 fingers. AHPFS-W outcome shows that patients undergoing sigmoid colon vaginoplasty and ZDV have relatively better pelvic floor muscle function. Patients undergoing skin flap vaginoplasty scored higher on the FGSIS, indicating a higher level of self-acceptance toward reconstructed genitalia.
Factors like anatomical characteristics, sexual customs and cultural backgrounds may alter the choice of GAS techniques for Chinese transgender females. The GAS surgical experience specialized to Chinese transgender females is necessary to share.
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由于某些原因，针对跨性别女性的性别肯定手术（GAS）在中国发展相对较晚且受限。介绍中国跨性别女性的性别肯定手术经验很有必要。
报告手术选择及经验，包括阴蒂/尿道重建、阴道成形术和外阴成形术及其结果。
对2018年9月至2023年3月期间接受性别肯定手术的跨性别女性进行单中心回顾性病例系列研究。评估手术结果，包括短期和长期并发症。采用瘢痕Q量表、女性性功能指数（FSFI）、阿姆斯特丹女性盆底肌过度活跃量表（AHPFS-W）和女性生殖器自我意象量表（FGSIS）进行结果评估。
13名跨性别女性接受了性别肯定手术。其中，7例患者接受了乙状结肠阴道成形术，3例患者接受了零深度阴道成形术（ZDV），3例患者接受了皮瓣（阴茎或阴囊）阴道成形术。术后随访显示，对于乙状结肠新阴道，阴道长度可达10-15厘米，宽度约为两指宽。对于皮瓣新阴道，长期阴道长度可维持在8-10厘米左右，宽度约为两指宽。AHPFS-W结果显示，接受乙状结肠阴道成形术和ZDV的患者盆底肌肉功能相对较好。接受皮瓣阴道成形术的患者在FGSIS上得分较高，表明对重建生殖器的自我接受程度较高。
解剖特征、性习俗和文化背景等因素可能会改变中国跨性别女性性别肯定手术技术的选择。分享针对中国跨性别女性的性别肯定手术经验很有必要。
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