What is a vaginoplasty?

Vaginoplasty is a gender affirmation surgery that creates a vaginal cavity and a vulva from existing genital tissue.

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What to expect step by step

1 – To Meet Criteria

First, one must meet the criteria for genital surgery from the World Professional Association for Transgender Health (WPATH). The person wishing to have vaginoplasty must be of legal age and able to provide informed consent. She must suffer from gender dysphoria (a distress related to the difference between the sex assigned at birth and her gender identity), have any medical or mental concerns well-controlled as well as having 12 months of hormone therapy treatment (unless there is medical contraindication) and of living in the congruent gender.

2 – Medical Consultations

Normally, the healthcare professionals of the person who wants to undergo a vaginoplasty at GrS Montreal will refer her to our services.

A team of nurse clinicians from the preoperative clinic will assess the patient’s health condition in collaboration with the medical team and will be available to answer any questions.

A consultation with the surgeon may be planned to explain the options and the surgical techniques. The doctor will also explain the risks and complications associated with the chosen genital surgery. The patient will be invited to ask any questions about surgery, possible risks and complications, postsurgical care, or any other subject related to vaginoplasty.

3 – Vaginoplasty: the Surgical Procedure

The surgery will be performed under local or general anesthesia.

First, the surgeon will remove the scrotum and the testicles.

To construct the opening of the urethra, the labia, and the clitoris, the surgeon will use the glans, the urethra, and the skin from the scrotum. Cauterization of hair follicles will be done to prevent hair growth in the vaginal cavity.

The glans is used to create the clitoris. The glans, like the clitoris, is sensitive. This usually helps maintain sexual sensations after surgery.

A vaginal cavity will be created. The prostate will not be removed as its removal may cause permanent urinary incontinence. In addition, the prostate remains a sensitive organ and an erogenous zone during intercourse involving penetration. The skin of the penis will be inverted to create the inner lining of the vagina. The surgeon will also use skin from the scrotum to complete the vaginal wall.

If the surgeon needs more skin to construct the new female organs, he could take skin from another part of the body such as the thigh. Even if this procedure is rare, you will be informed before the surgery if it is necessary.

A mould will be placed temporarily inside the vaginal cavity to prevent it from closing and will be removed between the 5^th and 7^th days after surgery. Then, the vaginal dilations will begin to keep the cavity open. Note that these dilations will have to be maintained for life.

4 – After the Vaginoplasty: the recovery

After the surgical procedure and the hospitalization at the Centre Métropolitain de Chirurgie, the patient will recover for a few days at the Maison de convalescence Asclepiade where trained professionals will answer all her questions and help her begin postoperative care.

In all, the healing will take about a year and the process will have to be managed with care.