The sexual function among transgender women who have undergone gender-affirming surgery using penile skin inversion vaginoplasty in Thailand

Background Gender dysphoria is a condition in which there is a discrepancy between gender identity and the birth-assigned sex. Its prevalence is rising worldwide. The primary objective of this study was to evaluate sexual function in transgender women after gender-affirming surgery using penile skin inversion vaginoplasty. The secondary objectives were to evaluate the most affected domain of the FSFI (female sexual function index) and quality of life (QOL) of these participants. Methods This was a cross-sectional study. The data was collected from 69 transgender women who have undergone penile skin inversion vaginoplasty >= 3 months prior to the study initiation. The participants were requested to fill out two questionnaires, the FSFI and WHOQOL-BREF. Sexual dysfunction was diagnosed in transgender women with FSFI score <= 26 that is traditionally classified as sexual dysfunction. Results Eighty-two percent (82.61%) of participants reported a total FSFI score of less than 26. The mean total FSFI score was 22.95, with the lowest score in lubrication domain. However, poor quality of life by WHOQOL-BREF was present in only 2.9% of the tested participants. Conclusions This study found a significant prevalence of sexual dysfunction by FSFI score in the transgender women who have undergone gender-affirming surgery using penile skin inversion. Quality of life by WHOQOL-BREF score was, however, generally high in this population. Level of evidence: Level IV, risk/prognostic study