Patient reports of motivations and preparation for penile prosthesis among transgender individuals

Penile prostheses are widely used to improve erectile function, yet existing research has largely focused on cisgender male patients, overlooking the unique experiences and needs of transgender individuals.

To explore the motivations and preparatory steps of transgender patients who pursue penile prosthesis implantation following phalloplasty.

Six virtual semi-structured interviews were conducted with transgender patients at a single institution who had undergone phalloplasty and subsequent penile prosthesis implantation between 2017 and 2023. Interviews were transcribed verbatim, and the data were analyzed using an inductive coding approach to identify key themes.

Analysis revealed two major themes: motivations for pursuing phalloplasty with penile prosthesis and preparatory steps taken. The three primary motivations described by respondents included alleviating gender dysphoria, improving sexual function, and achieving personal fulfillment through the completion of medical and surgical procedures. The key preparatory steps included seeking community and online social support, engaging with the medical care team, consuming scholarly medical literature, and attending academic conferences.

This study uncovers important aspects of transgender patients' journeys leading up to penile prosthesis procedures. Findings suggest that enhancing patient education and decision aids could improve the decision-making process for patients considering the procedure. This study underscores the importance of understanding and addressing the unique needs of transgender patients in gender-affirming care, and learning from them could help healthcare practitioners better support transgender individuals in their medical and penile prosthesis decision-making processes.