Transmen’s Experienced Sexuality and Genital Gender-Affirming Surgery: Findings From a Clinical Follow-Up Study

Grift, Tim C. van de; Pigot, Garry L.S.; Kreukels, Baudewijntje P.C.; Bouman, Mark‐Bram; Mullender, Margriet G.

doi:10.1080/0092623x.2018.1500405

Cited by 49 publications

(32 citation statements)

References 9 publications

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“…This was independent of the treatment of the clitoris and supports the concept that additional factors contribute to the ability to achieve orgasm. One potential contributing factor is the improvement that occurs in one's identity following phalloplasty [12] . van de Grift et al [12] report the development of positive self-esteem and affirmation of a masculine identity following phalloplasty.…”

Section: Discussionmentioning

confidence: 99%

“…One potential contributing factor is the improvement that occurs in one's identity following phalloplasty [12] . van de Grift et al [12] report the development of positive self-esteem and affirmation of a masculine identity following phalloplasty. This may facilitate engagement in and, enjoyment of, sexual activity including increased sexual initiative and pleasure.…”

Section: Discussionmentioning

confidence: 99%

“…Restoring genital sensibility is highly desired by patients, and a sensate neophallus is a major determinant of postoperative satisfaction [10,12] . Tactile sensation is important in reducing the risk of inadvertent injuries as well as providing protection for subsequent implantable penile prostheses [13] .…”

Section: Introductionmentioning

confidence: 99%

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Strategies for innervation of the neophallus

Hontscharuk¹,

Siotos²,

Schechter³

2020

Plast Aesthet Res

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A fundamental goal of phalloplasty includes the construction of a sensate neophallus. Both tactile and erogenous sensation are important for protective sensation (including retention of implantable penile prosthesis) as well as sexual satisfaction. This article will describe the sensory innervation of flaps commonly used for phalloplasty including the radial forearm flap, anterolateral thigh flap, and musculocutaneous latissimus dorsi flap. The sensory innervation of the perineum and external genitalia will be reviewed as a basis for selecting recipient nerves. Additionally, surgical techniques, such as neurorrhaphy, will be discussed. Finally, outcome data, although limited, will be assessed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Strategies for innervation of the neophallus

Hontscharuk¹,

Siotos²,

Schechter³

2020

Plast Aesthet Res

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“…Even though GASs have been performed for more than 50 years, little is known about their effects on the sexual experiences of transpeople, especially of transmen. Preoperative counseling with a sexologist, the treating surgeon, and a psychotherapist is very important to reveal the patient's sexuality and sexual functioning before the surgery, but will also be of essential importance after the GA [18] .…”

Section: Preoperative Evaluationmentioning

confidence: 99%

“…Patients after metoidioplasty report sexual intercourse in a broader sense than just penetration, with increased sexual initiative and pleasure [18] . Metoidioplasty, as a one-stage genital gender affirmation surgery, brings about 40% overall complication rate, the most common complications being related to urethral reconstruction.…”

Section: Operative Techniquesmentioning

confidence: 99%

Metoidioplasty as a one-stage phallic reconstruction in transmen

Bizic¹,

Stojanovic²,

Bencic³

et al. 2020

Plast Aesthet Res

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Gender dysphoria is a condition where there is a discrepancy between the gender assigned at birth and the desired gender, leading the patient to pursue surgical intervention. Reconstruction of the neophallus for transmen is still challenging, even though there are many surgical techniques with satisfying results. The aim of neophallic reconstruction in gender affirmation surgery (GAS) for transmen is to provide stand-up voiding, erotic sensation, orgasm and penetration ability, and acceptable donor site morbidity with minimal scarring and complications. Metoidioplasty as a variant of phalloplasty for transmen is a one-stage procedure that results in male-like external genitals, with minimal scarring, ability of standing micturition, and full erogenous sensation with the ability to achieve orgasm during sexual intercourse. Metoidioplasty is a method of choice for those transmen who wish to have GAS in one procedure without multi-staged procedures to create the adult-male-sized neophallus.

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Implementation of Patient-Reported Outcome Measures for Gender-Affirming Care Worldwide

et al. 2023

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ImportanceGender-affirming care is a key clinical area that can benefit from implementation of patient-reported outcome measures (PROMs). Identifying barriers to and enablers of PROM implementation is needed to develop an evidence-based implementation strategy.ObjectiveTo identify (1) PROMs previously implemented for gender-affirming care and constructs measured, (2) how patients completed PROMs and how results were reported and used, and (3) barriers to and enablers of PROM implementation.Evidence ReviewIn this systematic review, PubMed, Embase, MEDLINE, PsycINFO, CINAHL, and Web of Science were searched from inception to October 25, 2021, and updated on December 16, 2022. Gray literature was searched through gray literature database, online search engine, and targeted website searching. Inclusion criteria were (1) original articles of (2) a formally developed PROM or ad hoc instrument administered for gender-affirming care to (3) patients accessing gender-affirming care. The Critical Appraisal Skills Programme tool was used to evaluate quality of included studies. This review was registered on PROSPERO (CRD42021233080).FindingsIn total, 286 studies were included, representing 85 395 transgender and nonbinary patients from more than 30 countries. A total of 205 different PROMs were used in gender-affirming care. No studies described using an implementation science theory, model, or framework to support PROM deployment. Key barriers to PROM implementation included issues with evidence strength and quality of the PROM, engaging participants, and PROM complexity. Key enablers of PROM implementation included using PROMs validated for gender-affirming care, implementing PROMs able to be deployed online or in person, implementing PROMs that are shorter and reduce patient burden, engaging key stakeholders and participants as part of developing an implementation plan, and organizational climate.Conclusions and RelevanceIn this systematic review of barriers to and enablers of PROM implementation in gender-affirming care, PROM implementation was inconsistent and did not follow evidence-based approaches in implementation science. There was also a lack of patient input in creating implementation strategies, suggesting a need for patient-centered approaches to PROM implementation. Frameworks created from these results can be used to develop evidence-based PROM implementation initiatives for gender-affirming care and have potential generalizability for other clinical areas interested in implementing PROMs.

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Transmen’s Experienced Sexuality and Genital Gender-Affirming Surgery: Findings From a Clinical Follow-Up Study

Cited by 49 publications

References 9 publications

Strategies for innervation of the neophallus

Strategies for innervation of the neophallus

Metoidioplasty as a one-stage phallic reconstruction in transmen

Implementation of Patient-Reported Outcome Measures for Gender-Affirming Care Worldwide

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