ESSM Position Statement “Sexual Wellbeing After Gender Affirming Surgery”

Müjde Özer, MD, FECSM; Sahaand Poor Toulabi, MSc; Alessandra D. Fisher, MD, PhD, FECSM; Guy T'Sjoen, Prof. Dr; Marlon E. Buncamper, Prof. Dr; Stan Monstrey, Prof. Dr; Marta R. Bizic, MD, PhD; Miroslav Djordjevic, Prof. Dr; Marco Falcone, MD, FECSM; Nim A. Christopher, MD, PhD, FECSM; Daniel Simon, DMD; Luis Capitán, MD, PhD, OMFS; Joz Motmans, Prof. Dr

Sexual Medicine (Feb 2022)

ESSM Position Statement “Sexual Wellbeing After Gender Affirming Surgery”

Müjde Özer, MD, FECSM,
Sahaand Poor Toulabi, MSc,
Alessandra D. Fisher, MD, PhD, FECSM,
Guy T'Sjoen, Prof. Dr,
Marlon E. Buncamper, Prof. Dr,
Stan Monstrey, Prof. Dr,
Marta R. Bizic, MD, PhD,
Miroslav Djordjevic, Prof. Dr,
Marco Falcone, MD, FECSM,
Nim A. Christopher, MD, PhD, FECSM,
Daniel Simon, DMD,
Luis Capitán, MD, PhD, OMFS,
Joz Motmans, Prof. Dr

Affiliations

Müjde Özer, MD, FECSM: Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands; Corresponding Author: Müjde Özer, Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, De Boelelaan 1117, 1077MB Amsterdam, The Netherlands. Tel: +31 (0) 20 444 2965; Tel: +31 (0) 20 - 444 3261
Sahaand Poor Toulabi, MSc: Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
Alessandra D. Fisher, MD, PhD, FECSM: Andrology, Women's Endocrinology, Gender Incongruence Unit, Department of Experimental Clinical and Biomedical Sciences, University of Florence, Florence, Italy
Guy T'Sjoen, Prof. Dr: Department of Endocrinology and Center for Sexology and Gender, Ghent University and Ghent University Hospital, Ghent, Belgium
Marlon E. Buncamper, Prof. Dr: Department of Plastic, Reconstructive and Hand Surgery, Ghent University Hospital, Ghent, Belgium
Stan Monstrey, Prof. Dr: Department of Plastic, Reconstructive and Hand Surgery, Ghent University and Ghent University Hospital, Ghent, Belgium
Marta R. Bizic, MD, PhD: Department of Pediatric Urology, University of Belgrade, Belgrade, Serbia
Miroslav Djordjevic, Prof. Dr: Department of Pediatric Urology, University of Belgrade, Belgrade, Serbia
Marco Falcone, MD, FECSM: Department of Urology, Città della Salute e della Scienza, University of Turin, Turin, Italy
Nim A. Christopher, MD, PhD, FECSM: Department of Urology, St Peter's Andrology Centre and The Institute of Urology, London, UK
Daniel Simon, DMD: Facialteam Surgical Group, HC Marbella International Hospital, Marbella, Málaga, Spain
Luis Capitán, MD, PhD, OMFS: Facialteam Surgical Group, HC Marbella International Hospital, Marbella, Málaga, Spain
Joz Motmans, Prof. Dr: Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium

Journal volume & issue: Vol. 10, no. 1
p. 100471

Abstract

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Introduction: Much has been published on the surgical and functional results following Gender Affirming Surgery (‘GAS’) in trans individuals. Comprehensive results regarding sexual wellbeing following GAS, however, are generally lacking. Aim: To review the impact of various GAS on sexual wellbeing in treatment seeking trans individuals, and provide a comprehensive list of clinical recommendations regarding the various surgical options of GAS on behalf of the European Society for Sexual Medicine. Methods: The Medline, Cochrane Library and Embase databases were reviewed on the results of sexual wellbeing after GAS. Main Outcomes Measure: The task force established consensus statements regarding the somatic and general requirements before GAS and of GAS: orchiectomy-only, vaginoplasty, breast augmentation, vocal feminization surgery, facial feminization surgery, mastectomy, removal of the female sexual organs, metaidoioplasty, and phalloplasty. Outcomes pertaining to sexual wellbeing- sexual satisfaction, sexual relationship, sexual response, sexual activity, enacted sexual script, sexuality, sexual function, genital function, quality of sex life and sexual pleasure- are provided for each statement separately. Results: The present position paper provides clinicians with statements and recommendations for clinical practice, regarding GAS and their effects on sexual wellbeing in trans individuals. These data, are limited and may not be sufficient to make evidence-based recommendations for every surgical option. Findings regarding sexual wellbeing following GAS were mainly positive. There was no data on sexual wellbeing following orchiectomy-only, vocal feminization surgery, facial feminization surgery or the removal of the female sexual organs. The choice for GAS is dependent on patient preference, anatomy and health status, and the surgeon's skills. Trans individuals may benefit from studies focusing exclusively on the effects of GAS on sexual wellbeing. Conclusion: The available evidence suggests positive results regarding sexual wellbeing following GAS. We advise more studies that underline the evidence regarding sexual wellbeing following GAS. This position statement may aid both clinicians and patients in decision-making process regarding the choice for GAS. Özer M, Toulabi SP, Fisher AD, et al. ESSM Position Statement “Sexual Wellbeing After Gender Affirming Surgery”. Sex Med 2022;10:100471.

Published in Sexual Medicine

ISSN: 2050-1161 (Online)
Publisher: Oxford University Press
Country of publisher: United Kingdom
LCC subjects: Medicine
Website: https://academic.oup.com/smoa

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