ESSM Position Statement "Sexual Wellbeing After Gender Affirming Surgery"

Area of Science:

• Medical Science
• Surgical Procedures
• Transgender Health

Background:

• Extensive research exists on surgical and functional outcomes of Gender Affirming Surgery (GAS).
• However, comprehensive data on sexual wellbeing following GAS remains limited.
• This gap highlights a need for focused investigation into sexual health post-surgery.

Purpose of the Study:

• To review the impact of diverse GAS procedures on sexual wellbeing in transgender individuals.
• To provide clinical recommendations for surgical options in GAS from the European Society for Sexual Medicine.
• To address the lack of comprehensive data on sexual health outcomes after GAS.

Main Methods:

• Systematic literature review of Medline, Cochrane Library, and Embase databases.
• Consensus statements were developed for various GAS procedures, including orchiectomy, vaginoplasty, breast augmentation, and others.
• Outcomes related to sexual satisfaction, function, activity, and pleasure were assessed for each procedure.

Main Results:

• Findings on sexual wellbeing following GAS were predominantly positive.
• Data on sexual wellbeing was unavailable for specific procedures like orchiectomy-only, vocal feminization, facial feminization, and removal of female sexual organs.
• The selection of GAS depends on patient preferences, anatomy, health, and surgeon expertise.

Conclusions:

• Available evidence indicates positive impacts of GAS on sexual wellbeing.
• Further studies are recommended to strengthen the evidence base for sexual wellbeing outcomes after GAS.
• This position statement aims to assist clinicians and patients in making informed decisions regarding GAS.