If you are a trans woman who has recently undergone a vaginoplasty gender-affirming surgery, there is a chance that you could be dealing with some form of female sexual dysfunction.
Changes to sexual function can be a common issue during gender-affirming surgery recovery. Having a major change to the genital region can impact sexual health, including changes in sexual arousal and sexual desire (usually developing a low sexual desire), difficulties with sexual functioning, new sexual pain during sexual intercourse, and other sexual problems.
Here, we’re going to take a closer look at changes to female sexual function trans women may face after surgery. Then, we’ll explore some of our top tips for trans women who experience sexual dysfunction.
What Kinds of Sexual Dysfunction Do Trans Women Experience?
A trans woman who has recently undergone a vaginoplasty will have a lot of questions about possible changes to their sexual function after surgery. Though these are not experienced by all patients, here are some of the potential sexual problems patients can face following a vaginoplasty procedure:
Sexual Arousal Aversion/Difficulties and Change to Sexual Desire
One of the major changes patients may notice during recovery are changes in sexual arousal and sexual desire. In most cases, patients may find they lack their usual sexual response arousal level and have a lack of overall sexual interest.
Changes to sexual responsiveness during recovery can happen for a variety of reasons. In many cases, it is simply the mental load of the healing process that leads to a lower-than-average sexual drive, with sexual interest going back to normal as patients recover.
In some cases, though, prolonged changes to libido and desire can be cause for concern. Gender-affirming surgeries like a vaginoplasty are a massive change for trans women, physically and mentally. In some cases, patients may find they need to mentally work through this physical change and the impact of previous gender dysphoria on their mindset to deal with sexual problems related to low sexual desire.
Some patients may find that even well into recovery, they still experience sexual difficulty. In these cases, a healthcare professional can help a patient determine if the cause of the issue is mental, physical, or some kind of deeper arousal disorder.
Difficulties Achieving Orgasm
Similar to the issue addressed above, some trans women may find they have difficulty achieving orgasm after a vaginoplasty, even with sexual stimulation.
This can be an extremely frustrating result for patients whose goal with surgery was to resume their usual sexual activity. Again, these kinds of difficulties during sexual activity can be linked to negative mental states during recovery, or it can just be a symptom of the healing process.
It can take longer than you’d think to fully recover and go back to normal sexual function. In a 2022 study from J Sex Med, it was found that while up to 86% of trans women after vaginoplasty were able to achieve orgasm, this milestone was achieved 6 months to 1 year after surgery.
Healing is a long process, but it is possible to get back to regular orgasm sensations with time and patience! This is why in most patients with an orgasm issue, the ability to achieve female sexual function after surgery is simply a matter of taking time to heal. However, if sexual functioning issues are still happening a year post-surgery, it may be time to see a sexual health practitioner.
Difficulties Initiating Sexual Activity
Another block trans women may face during sexual activity after receiving gender-affirming surgery is difficulty with initiating sex.
Some trans women may find themselves dealing with feelings of dysphoria around their new genitalia. There could also be a lack of comfort with their new genitalia, a lack of familiarity, and a nervousness to engage in sexual activity preventing them from engaging with it.
In these cases, it’s best to work on feelings of dysphoria, body image, and self-esteem. Seeing a therapist can do wonders here, assisting patients as they take steps to work on their confidence to engage in a sexual act in the future.
3 Tips for Trans Women Experiencing Female Sexual Dysfunction
To prevent female sexual dysfunction following a vaginoplasty procedure, here are our top three tips:
Delay Sexual Intercourse During Recovery
The most important thing you can do to prevent a potential sexual dysfunction or sexual disorder following surgery is to give the vagina adequate time to recover. If you engage in sexual activity too early, it can lead to potential wounds/infections, and other women’s health complications.
According to John Hopkins, patients should wait a minimum of 12 weeks following surgery before attempting any kind of sexual activity. After 12 weeks, patients can begin to initiate sex, and should hopefully begin to have clitoral sensation during sexual stimulation.
Address Pelvic Floor Health with a Healthcare Professional
Another great tip for vaginoplasty patients is to use the services of a pelvic floor physiotherapist during recovery. A pelvic floor therapist can suggest different exercises to get you back to your healthiest self, including pelvic floor exercises, massage therapy, and other treatment options.
One of the biggest things a physiotherapist will assist patients with following vaginoplasty is the dilator process. In order to maintain vaginal depth/width during the healing process. This process will involve lubricating and inserting dilators into the vagina daily for extended periods of time to assist with healing and comfort. A physiotherapist can help to monitor this process during recovery.
Support Your Mental Health
Last, but certainly not least, trans women experiencing female sexual dysfunction need to prioritise their mental health.
For many trans women, gender-affirming surgery like a vaginoplasty can be life-changing due to the ways they save mental health. In fact, a Harvard study has indicated gender affirming surgery leads to a 42% reduction in psychological distress in trans women when compared to those who have not received surgery.
As you recover from surgery, it is important to acknowledge the way it will impact mental health as a whole. A vaginoplasty represents not only a massive physical change but a huge mental shift, especially for patients with dysphoria looking to achieve the genitalia they desire. Remember to support your mental health, just as much as your physical health, during the recovery process.