Postoperative Vaginoplasty Outcomes for Transgender and Nonbinary Patients in a U.S. County Safety-Net Health System

Area of Science:

• Medical research
• Surgical outcomes
• Gender-affirming care

Background:

• Transgender and nonbinary (TNB) individuals often face barriers to gender-affirming care.
• Vaginoplasty is a key component of gender affirmation surgery.
• Establishing surgical programs in safety-net hospitals can improve access to care.

Purpose of the Study:

• To characterize postoperative outcomes for transgender and nonbinary (TNB) patients undergoing vaginoplasty.
• To identify demographic and medical factors associated with surgical outcomes.
• To evaluate the safety and feasibility of a newly established vaginoplasty program in a safety-net hospital.

Main Methods:

• Retrospective chart review of electronic medical records for patients who underwent vaginoplasty (May 2018-April 2021).
• Data collected included demographics, surgical complications (major/minor), postoperative visits, physical therapy outcomes, and narcotic usage.
• Descriptive and bivariate statistical analyses were performed.

Main Results:

• 153 patients underwent vaginoplasty; 150 were included in the analysis with a median follow-up of 3.6 months.
• Major and minor complication rates were 28% and 66.7%, respectively. Common major complications included hemorrhage and infection.
• No demographic or medical characteristics were significantly associated with surgical complications.

Conclusions:

• Vaginoplasty complication rates in this safety-net hospital program were comparable to published ranges.
• The findings support the safety and feasibility of providing vaginoplasty in safety-net settings.
• This study highlights the potential for expanded access to gender-affirming surgeries.