A Review of Alternative Gender-Affirming Genital Surgeries: Options and Outcomes

What is it about?

The review explores variant genital gender-affirming surgery (GGAS) by examining literature on different surgical techniques and their outcomes, including the motivations behind these procedures. A systematic review, following PRISMA guidelines and assessing bias, analyzed 23 case series on masculinizing and feminizing surgeries. The review found that patients often choose these surgeries to avoid complications or due to lack of dysphoria about certain genital parts. Complications in masculinizing surgeries were mainly related to urethral issues, which could be mitigated through specific surgical techniques, while feminizing surgeries without vaginal canal creation avoided the need for lifelong self-dilation. The review emphasizes the importance of personalized GGAS options, recognizing diverse gender perspectives and the necessity for informed decision-making based on risks and benefits. However, it highlights the need for more high-quality, long-term research to fully understand the outcomes, satisfaction, quality of life, and sexual function associated with these surgeries.

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Why is it important?

This research is significant because it provides a comprehensive review of variant genital gender-affirming surgeries (GGAS), addressing an important gap in the literature. By exploring surgical options that deviate from traditional binary gender norms, this study acknowledges the diverse needs and preferences of transgender and gender-diverse individuals. Understanding the outcomes, complications, and patient motivations for these variant procedures is crucial for improving patient care, informed decision-making, and expanding the range of available treatment options in gender-affirming care. Key Takeaways: 1. Personalized Care: The study highlights the importance of individualized GGAS, recognizing that not all patients desire or require complete binary gender-aligned surgeries, emphasizing the need for flexible and patient-centered approaches in transgender healthcare. 2. Complication Risks: The review reveals that certain variant procedures, such as masculinizing surgeries without urethral lengthening or feminizing surgeries without vaginal canal creation, may have lower complication rates compared to traditional approaches, providing valuable information for surgical planning and patient counseling. 3. Research Gaps: The study identifies a significant lack of long-term data and high-quality research on variant GGAS, particularly regarding patient satisfaction, quality of life, and sexual function, emphasizing the need for further comprehensive studies to inform ethical decision-making and improve patient outcomes.