Trans men opting for gender-affirming surgery can anticipate changes in their sexual anatomy and functions: a comprehensive guide
In the realm of gender-affirming surgeries, phalloplasty stands as a significant procedure for transgender men. This operation involves creating a penis, lengthening the urethra, creating the glans, crafting a scrotum, removing the vagina, and inserting testicular and erectile implants.
After undergoing phalloplasty, it is crucial for patients to exercise patience during the recovery period, as the phallus and urethra require substantial healing time to reduce risks of complications such as fistulas or strictures. Typically, a trans man should wait around 6 to 12 weeks before engaging in sexual activity, particularly penetrative sex. During this time, it is essential to avoid putting pressure on the neophallus and any inserted erectile device.
The sexual experiences following phalloplasty may differ depending on surgical techniques and the use of erectile implants. Sensation is often reduced compared to metoidioplasty, as phalloplasty involves tissue grafts from donor sites and may not preserve nerve endings completely. However, some sensation can return over time, and orgasm remains possible.
Phalloplasty usually requires an erectile prosthesis to achieve rigidity sufficient for penetrative sex. Patients with such implants can expect to engage in penetrative intercourse, though healing and device management require care. The phallus created by phalloplasty is generally larger and may appear more natural-looking compared to metoidioplasty, but it comes with longer healing times and higher risk of complications.
To ensure optimal sexual health outcomes, it is essential to follow the advice of the surgical team. Sexual health tips after phalloplasty include:
- Following surgeon-specific guidelines on wound care to prevent infection and promote healing.
- Beginning gradual pelvic floor exercises and Kegel exercises as recommended to improve erectile function and comfort.
- Communicating openly with sexual partners about comfort levels and any pain or sensitivity changes.
- Using lubricants during sex to reduce friction and avoid trauma.
- Regular follow-up with the surgeon or urologist to monitor healing, especially of the urethra, and to address any complications early.
- Being patient with sensation and sexual function, as it may take months to adjust and achieve desired function.
Overall, sexual activity should resume only after surgeon clearance, which commonly occurs around 6-12 weeks post-op, but individual healing times vary. As phalloplasty is a complex, staged procedure with risks of complications, individualized advice from the surgical team is essential for optimal sexual health outcomes.
It is important to note that metoidioplasty, another gender-affirming surgery, generally has shorter healing times and preserves more natural sensation, but results and considerations differ from phalloplasty.
References:
[1] Mayo Clinic. (2021). Phalloplasty. https://www.mayoclinic.org/tests-procedures/phalloplasty/about/pac-20394876
[2] American Society of Plastic Surgeons. (2021). Phalloplasty. https://www.plasticsurgery.org/cosmetic-procedures/phalloplasty/phalloplasty-procedure-and-recovery
- After a type of gender-affirming surgery called phalloplasty, patients need to practice patience during recovery to minimize risks of complications like fistulas or strictures.
- Typically, a trans man should wait 6 to 12 weeks before resuming sexual activity, with special caution taken when engaging in penetrative sex.
- During this recovery period, it is advisable to avoid putting pressure on the neophallus and any inserted erectile device.
- Sexual experiences after phalloplasty can vary, with reduced sensation compared to metoidioplasty due to tissue grafts and incomplete preservation of nerve endings.
- Over time, some sensation can return, and orgasm remains possible.
- Phalloplasty often necessitates the use of an erectile prosthesis for adequate rigidity for penetrative sex.
- Sexual health tips following phalloplasty encompass adhering to surgeon-specific wound care guidelines, practicing pelvic floor exercises, communicating with sexual partners, using lubricants, and scheduling regular follow-ups.
- Being patient with sensation and sexual function is crucial, as it could take months to adjust and achieve desired results.
- Sexual activity should only commence after receiving surgeon clearance, which usually occurs around 6-12 weeks post-op, but individual healing times may differ.
- In addition to phalloplasty, another gender-affirming surgery, metoidioplasty, has shorter healing times and preserves more natural sensation, although results and considerations vary.
- For optimal sexual health outcomes, it is crucial to seek individualized advice from the surgical team and refer to scientific resources related to health-and-wellness, sexual-health, mental-health, and obesity, as well as professional organizations such as the Mayo Clinic and American Society of Plastic Surgeons.
