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Transgender Vulvar and Clitoral Anatomy: A Guide for Gynecologists
Sara Rahman1, Cecile A Ferrando
1Division of Urogynecology and Pelvic Floor Disorders, Ob/Gyn & Women's Health Institute, Cleveland Clinic, Cleveland, Ohio; and the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of OBGYN & Reproductive Sciences, University of California, San Diego, San Diego, California.
Background:
It is important for gynecologists to understand postoperative anatomy to provide inclusive and competent care to patients who have undergone gender-affirming vaginoplasty. The neoclitoris and neovula differ from cisgender anatomy. This article and associated video address these knowledge gaps to enhance gynecologic care for transgender patients.
Technique:
We review the steps of penile inversion vaginoplasty, focusing on the creation of the neoclitoris and neovulva. The key differences and similarities between cisgender and transgender clitoral anatomy are highlighted. A detailed examinator of the neurovascular components emphasizes their role in sensation and function.
Experience:
The senior author, a board-certified urogynecologist, has performed nearly 300 vulvoplasty and vaginoplasty procedures. Many transgender patients face barriers to competent gynecologic care. We created this video to bridge those gaps by enhancing gynecologist's understanding of gender-affirming surgery and postoperative anatomy.
Conclusion:
A thorough understanding of transgender anatomy and function enables gynecologists to provide high-quality care in an inclusive and supportive environment.
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