Does size matter? Genital self-image, genital size, pornography use and openness towards cosmetic genital surgery in 3662 Swedish men and women

This cross-sectional study investigated the distribution and characteristics of genial self-image in a large sample of males and females, and whether factors such as actual genial size (length of penis or protrusion of labia minora), consumption of sexually explicit material (SEM) or avoidance and safety seeking behaviors were associated with genital self-image. Overall, 3.6% of females and 5.5% of males suffered from a severely low genital self-image and 33.8% of all individuals reported dissatisfaction with the appearance of their genitalia, with 13.7% of females and 11.3% of males being positive towards undergoing cosmetic genital surgery. Mean protrusion of labia minora and stretched flaccid penis length in the population was estimated to 0.76 cm (95% CI 0.63-0.89 cm) and 12.5 cm (95% CI 12.33-12.76 cm), respectively. A better genital self-image was associated with having a larger penis or less protruding labia minora, but not associated with the degree of SEM consumption, although 93.6% of males and 57.5% of females had consumed SEM in the past three months. Avoidance and safety seeking behaviors were strongly correlated with a negative genital self-image. Considering this relationship, more research is warranted in the development of potential psychological interventions in order to alleviate genital dissatisfaction in individuals.

Anatomical and sexual health considerations among transfeminine individuals who have undergone vaginoplasty: A review

As acceptance of transgender and gender diverse individuals continues to increase, gender-affirming surgery, a cornerstone in the management of gender dysphoria, is becoming more readily available. HIV and sexually transmitted infections (STIs) disproportionately affect these populations, but there are limited epidemiologic and management data on STIs in people who have undergone gender-affirming genital surgery such as vaginoplasty. This review will provide clinicians with anatomical details about the various vaginoplasty procedures currently being performed, complications associated with these procedures, and an overview of the current literature describing HIV/STI epidemiology among transfeminine individuals who have undergone vaginoplasty.

Preferences for Gender Affirming Treatment and Associated Factors Among Transgender People in Sweden

Introduction Gender affirming surgery of primary and/or secondary sex characteristics has been shown to alleviate gender dysphoria. A descriptive snapshot of current treatment preferences is useful to understand the needs of the transgender population seeking health care. This study aimed to describe preferences for gender affirming treatment, and their correlates, among individuals seeking health care for gender dysphoria in Sweden after major national legislative reforms. Methods Cross-sectional study where transgender patients (n = 232) recruited from all six Gender Dysphoria centers in Sweden 2016–2019, answered a survey on treatment preferences and sociodemographic, health, and gender identity-related information during the same time-period. Factors associated with preferring top surgery (breast augmentation or mastectomy), genital surgery, and other surgery (e.g., facial surgery) were examined in univariable and multivariable regression analyses in the 197 people without prior such treatment. Main study outcomes were preferences for feminizing or masculinizing hormonal and surgical gender affirming treatment. Results The proportion among birth assigned male and assigned female patients preferring top surgery was 55.6% and 88.7%, genital surgery 88.9% and 65.7%, and other surgery (e.g., facial surgery) 85.6% and 22.5%, respectively. Almost all participants (99.1%) wanted or had already received hormonal treatment and most (96.7%) wished for some kind of surgical treatment; 55.0% wanted both top and genital surgery. Preferring a binary pronoun (he/she) and factors indicating more severe gender incongruence were associated with a greater wish for surgical treatment. Participants with somatic comorbidities were less likely to want genital surgery, while aF with lacking social support were less likely to want internal genital surgery, in the multivariable analyses. Conclusions In this sample of Swedish young adults seeking health care for gender dysphoria, preferences for treatment options varied according to perceived gender identity. Policy Implications The study findings underline the need for individualized care and flexible gender affirming treatment options. The role of somatic comorbidities should be further explored, and support should be offered to transgender people in need. There is an unmet need for facial surgery among aM.

Cosmetic surgical procedures on the vulva and vagina – an overview

Cosmetic surgery is defined as any procedure involving a change in the appearance or aesthetics of a normal anatomy where there are no congenital or acquired pathologies. The procedures that can be included under female cosmetic genital surgery are the following: reduction labiaplasty, vaginoplasty, hymenoplasty, “G-Spot amplification”, and miscellaneous. Those who support these procedures could argue that women undergo such procedures as a matter of choice, whereas those opposed could argue that this choice is made because of society’s fascination with physical appearance and feeling young. Prima facie these procedures appear to contradict the Hippocratic principle of “primum non nocere”. There has been an increase in the marketing and conduct of the above mentioned procedures. Practitioners need to be both sceptical and cautious while performing these surgeries. Patients requesting them need to be counseled regarding the lack of data supporting their efficacy, and the potential complications of the procedures.

Physical and Sociodemographic Features Associated With Quality of Life in Transgender Individuals Using Gender-Affirming Hormone Therapy

Background: Gender dysphoria is defined as a feeling of distress resulting from the incongruence between the gender assigned at birth and the identity gender and lasting longer than 6 months. In individuals with gender dysphoria, gender-affirming hormone therapy(GAHT) may improve quality of life (QoL). Objectives: Here, we aimed to assess perceived QoL and possible contributing factors in a sample of transgender women and transgender men using GAHT. Methods: In this cross-sectional study, transgender women and men were recruited by availability sampling from a national transgender health service. Individuals over 18 years old with a confirmed diagnosis of gender dysphoria receiving medically prescribed GAHT for at least 6 months were consecutively included. Also included were trans men who had undergone mastectomy and trans women who had received breast augmentation surgery. Individuals who had undergone gender affirmation surgery (specifically genital surgery) or with uncontrolled clinical/psychiatric conditions at the time of the initial assessment were excluded. Sociodemographic, physical, and hormone data were collected from all participants. The WHOQOL-BREF questionnaire was used to evaluate QoL. A total of 135 transgender individuals were invited. Seventeen individuals with previous genital surgery (12.6%) and five who refused to participate (3.7%) were excluded. Therefore, 113 patients were enrolled in the study (60 trans women and 53 trans men). Results: There was no significant difference in QoLbetween the groups. In trans women, greater breast development and stable relationships, and higher body mass index were associated with higher QoLdomain scores. In trans men, higher domain scores were found in individuals with a stable relationship, increased body hair, physical activity practice, and being employed. Conclusion: Data from this study suggest that GAHT-related physical characteristics are associated with higher QoLscores, and that sociodemographic parameters may impact these associations. Healthcare providers might consider these factors when planning interventions to improve QoLin transgender individuals.