Ramsay Alyxandra, Blankson Jo, Finnerty-Haggerty Lara, Wu Jiaxin, Safer Joshua D, Pang John Henry
Mount Sinai Heath System, Center for Transgender Medicine and Surgery, 275 7th Avenue, 15th Floor, New York, NY 10001, USA.
State University of New York, Downstate College of Medicine, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
Sex Health. 2025 Jan;22. doi: 10.1071/SH24070.
Background In the healthcare setting, transgender patients are often marginalized, face discrimination and have limited access to high-quality gender-affirming care, such as gender-affirming surgery (GAS). As a result, the available data pertaining to GAS are often based on convenience samples, and the majority of published studies in the US are cross-sectional. Transgender people may undergo GAS to align their bodies with their gender identities. There has been little emphasis on the GAS self-evaluated experience. GAS may be associated with improved quality of life in transgender people. This study aimed to analyze the functionality of transgender patients' genitals following vaginoplasty. Methods A total of 306 transgender patients responded to a validated survey for patient-reported feminizing GAS outcomes. Surveys were given to patients prior to GAS, and then 2weeks, 6months and 12months postoperatively. Pre- and post-GAS responses were compared using McNemar and Wilcoxon signed-rank tests. Self-identified race/ethnicity was available for all survey participants. All participants voluntarily took the same survey by using the same survey platform to eliminate bias. Results Five questions showed significant improvement between the 2-week and 6-month responses. These questions assessed if respondents had sensation in their clitoris (P =0.031), the frequency that clitoral stimulation was pleasurable (P =0.018), the presence of sexual activity in the past 3months (P P =0.031) and if labial irritation while walking or exercising decreased (P =0.051). Significant differences were not detected between the 6-month and 12-month responses for any of the survey questions. Conclusions The results of five different metrics regarding sexual activity and vaginal functioning showed a significant improvement for transgender people following GAS. Findings also similarly demonstrate a high success rate of sexual activity after GAS. These are significant patient-reported outcomes using tools validated for the transgender population. Respondent outcomes significantly improved between the 2-week and 6-month time period, but did not differ between the 6-month and 12-month period, suggesting the ideal time to assess the above-described patient-perceived outcomes with vaginoplasty is 6months postoperatively.
背景 在医疗环境中，跨性别患者常常被边缘化，面临歧视，获得高质量性别肯定治疗（如性别肯定手术，GAS）的机会有限。因此，与性别肯定手术相关的现有数据往往基于方便样本，而且美国大多数已发表的研究都是横断面研究。跨性别者可能会接受性别肯定手术，以使自己的身体与性别认同相符。此前很少有人关注性别肯定手术的自我评估体验。性别肯定手术可能与跨性别者生活质量的改善有关。本研究旨在分析阴道成形术后跨性别患者生殖器的功能。
方法 共有306名跨性别患者对一份经过验证的关于患者报告的女性化性别肯定手术结果的调查问卷做出了回应。在性别肯定手术前、术后2周、6个月和12个月向患者发放调查问卷。使用麦克尼马尔检验和威尔科克森符号秩检验比较性别肯定手术前后的回答。所有调查参与者的自我认定种族/族裔信息均可得。所有参与者通过使用相同的调查平台自愿参与同一份调查问卷，以消除偏差。
结果 五个问题在术后2周和6个月的回答之间显示出显著改善。这些问题评估了受访者阴蒂是否有感觉（P = 0.031）、阴蒂刺激带来愉悦感的频率（P = 0.018）、过去3个月内是否有性行为（P = 0.031）以及行走或锻炼时阴唇刺激感是否减轻（P = 0.051）。对于任何调查问题，6个月和12个月的回答之间均未检测到显著差异。
结论 关于性行为和阴道功能的五个不同指标的结果显示，性别肯定手术后跨性别者有显著改善。研究结果同样表明性别肯定手术后性行为的成功率很高。这些是使用针对跨性别群体验证的工具得出的重要患者报告结果。受访者的结果在术后2周和6个月期间有显著改善，但在6个月和12个月期间没有差异。这表明评估上述阴道成形术患者感知结果的理想时间是术后6个月。
