Vaginal Health and Practices of Transwomen Who Have Undergone Vaginoplasty

Vaginal Health and Practices of Transwomen Who Have Undergone Vaginoplasty

Vaginoplasty is a surgical procedure that some transgender women or gender-diverse individuals assigned male at birth may choose to undergo. It involves creating a vaginal canal and, if desired, a vulva to affirm one’s gender identity.

Little is known about the vaginal practices and care of individuals post-vaginoplasty, despite the great importance of this topic for their well-being. As such, a recent study looked into the gynecological concerns and practices of individuals in Canada who have undergone vaginoplasty at least one year ago.

By surveying participants about their gynecological concerns and vaginal practices, the authors of the study aimed to identify clusters of people with similar experiences to shed light on the vaginal health and practices of this population as a whole.

A total of 60 individuals who had undergone vaginoplasty at least one year prior participated in the study. These people completed an online survey that included questions about their demographic information, gynecological concerns, and genital practices and exposures, including douching, dilating, receptive sexual activity, lubricant use, hygienic practices, and local or systemic medications/treatments.

In this nonrandom sample of participants, 85% had at least one gynecological concern since their vaginoplasty, and 61% had a concern within the past year. Common worries included healing issues (50%), excessive tissue growth (hypergranulation) (42%), and urinary tract infections (UTIs) (30%).

The most common concerns participants had within the past year were internal hair growth (23%), healing issues (16%), and UTIs (13%). Lastly, 56% had experienced recent vaginal symptoms, including odor (27%) and vaginal bleeding (21%).

Regarding vaginal practices and exposures, almost half (48%) were dilating weekly, and 52% had douched in the last month.

Through a special type of statistical analysis, the researchers discovered 4 clusters of vaginal practices among the participants: limited exposures; dilating, no douching; dilating and douching; and diverse exposures.

The first group (7 individuals) had minimal exposures, with none reporting douching, dilating, or having sex. The second group (20 individuals) focused on dilating, not douching, indicating high frequencies of intravaginal insertion (like dilating or having receptive sex) and using lubricants.

The third group (14 individuals) engaged in both dilating and douching, with frequent use of water for douching, dilating, and exposure to lubricants. Finally, the fourth group (15 individuals) had diverse exposures, including using solutions other than water for douching, intravaginal insertion, lubricants, hygienic wipes, and probiotics.

The researchers did not find any significant associations between the type of cluster and a person’s gynecological concerns. However, given how widely vaginal care practices and treatment strategies varied among the participants, it is clear that evidence-based guidelines on how to care for one’s vagina post-vaginoplasty would be very useful.

In the meantime, individuals who have undergone vaginoplasty may find it helpful to seek support and advice from medical professionals with experience in gender-affirming care. In this way, they may be better equipped with information on how to care for their vaginas in a healthy way.


  • Hallarn, J., Bauer, G.R., Potter, E., Wilcox, H., Newfeld, J., Krakowsky, Y., Ravel, J., & Prodger, J.L (2023). Gynecological concerns and vaginal practices and exposures among transfeminine individuals who have undergone vaginoplasty. The Journal of Sexual Medicine20(11), 1344-1352.

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