{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:19:25Z","timestamp":1786123165485,"version":"build-2736575974"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Patient-reported outcomes following gender affirming vaginoplasty remain understudied. The aim of this study was to evaluate patient-reported outcomes during the first postoperative year following penile inversion vaginoplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included n\u00a0=\u200976 consecutive patients undergoing penile inversion vaginoplasty (March 2021-January 2024) who completed questionnaires pre-op, and at 1, 3-, 6-, 9-, and 12-months post-op (n\u00a0=\u200959, 78%). Patient-reported satisfaction with functional and anatomic outcomes including improvements in gender dysphoria were compared with logistic regression, cumulative link mixed models, and Mann\u2013Whitney U tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Vaginoplasty reliably improved patient reports of matching gender identity (P\u00a0&amp;lt;\u2009.0001), comfort in clothes (P\u00a0&amp;lt;\u2009.0001), and reduced feelings of embarrassment (P\u00a0&amp;lt;\u2009.0001) and distress when looking at or touching the genitals (each P\u00a0&amp;lt;\u2009.0001). Fifty percent of respondents reached the #4 dilator by 6 months. At 1\u00a0year, the reported average vaginal depth was 12.7\u00a0cm (min 8.9\u00a0cm, max 14.0\u00a0cm), and 60% of patients had no issues with dilation. Slight or moderate difficulty was reported by 54% of respondents during the first 3\u00a0months, while 20% progressed to severe difficulty or complete cessation, beginning at 6\u00a0months and peaking at 9\u00a0months post-op. Three patients reported inability to dilate (6\u201312\u00a0months), all with preceding difficulties. Respondents were more likely to endorse ability to engage in their preferred sexual activity after vaginoplasty (P\u00a0&amp;lt;\u2009.0001). Return of genital sensation was gradual, with 100% of patients having at least partial sensation at 6\u00a0months and 61% describing full sensation by 1 year (P\u00a0&amp;lt;\u2009.001). Of those who had attempted to achieve orgasm, all were able at 9\u00a0months (P\u00a0&amp;lt;\u2009.001). Respondents reported greater satisfaction with urinary function post-operatively (P\u00a0&amp;lt;\u2009.001), despite 25% having diverted stream. All but 1 participant, who had a complicated post-op course, agreed with the statement \u201cI am now happier after my surgery than before my surgery\u201d at 1-year. Mental health concern prevalence remained stable over the course of 1\u00a0year (time effect P\u00a0=\u2009.64).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>During the first year after penile inversion vaginoplasty, we found high patient satisfaction for functional outcomes and alleviation of gender dysphoria. Results may assist in pre-operative counseling surrounding goals and expectations, increasing patient involvement, preparedness, and thereby outcomes and satisfaction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdag236","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:49:51Z","timestamp":1784116191000},"source":"Crossref","is-referenced-by-count":0,"title":["Gender affirming penile inversion vaginoplasty: patient-reported outcomes of the first year"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6025-0915","authenticated-orcid":false,"given":"Lauren","family":"Pickel","sequence":"first","affiliation":[{"name":"Temerty Faculty of Medicine, University of Toronto , Toronto, ON , M5S 3K3,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emery","family":"Potter","sequence":"additional","affiliation":[{"name":"Transition Related Surgery Program, Women\u2019s College Hospital , Toronto, ON , M5S 1B2,","place":["Canada"]},{"name":"Lawrence S. Bloomberg Faculty of Nursing, University of Toronto , Toronto, ON , M5S 3K3,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"MacLeod","sequence":"additional","affiliation":[{"name":"Transition Related Surgery Program, Women\u2019s College Hospital , Toronto, ON , M5S 1B2,","place":["Canada"]},{"name":"Lawrence S. Bloomberg Faculty of Nursing, University of Toronto , Toronto, ON , M5S 3K3,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Drodge","sequence":"additional","affiliation":[{"name":"Transition Related Surgery Program, Women\u2019s College Hospital , Toronto, ON , M5S 1B2,","place":["Canada"]},{"name":"Department of Physical Therapy, University of Toronto , Toronto, ON , M5S 3K3,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan D","family":"Grober","sequence":"additional","affiliation":[{"name":"Transition Related Surgery Program, Women\u2019s College Hospital , Toronto, ON , M5S 1B2,","place":["Canada"]},{"name":"Division of Urology, Department of Surgery, University of Toronto , Toronto, ON , M5S 3K3,","place":["Canada"]},{"name":"Division of Urology, Department of Surgery, Mount Sinai Hospital , Toronto, ON , M5G 1X5,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonah","family":"Krakowsky","sequence":"additional","affiliation":[{"name":"Transition Related Surgery Program, Women\u2019s College Hospital , Toronto, ON , M5S 1B2,","place":["Canada"]},{"name":"Division of Urology, Department of Surgery, University of Toronto , Toronto, ON , M5S 3K3,","place":["Canada"]},{"name":"Division of Urology, Department of Surgery, Mount Sinai Hospital , Toronto, ON , M5G 1X5,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra L","family":"Millman","sequence":"additional","affiliation":[{"name":"Transition Related Surgery Program, Women\u2019s College Hospital , Toronto, ON , M5S 1B2,","place":["Canada"]},{"name":"Division of Urology, Department of Surgery, University of Toronto , Toronto, ON , M5S 3K3,","place":["Canada"]},{"name":"Division of Urology, Department of Surgery, Mount Sinai Hospital , Toronto, ON , M5G 1X5,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3894-1899","authenticated-orcid":false,"given":"Yulia Wilk","family":"Goldsher","sequence":"additional","affiliation":[{"name":"Transition Related Surgery Program, Women\u2019s College Hospital , Toronto, ON , M5S 1B2,","place":["Canada"]},{"name":"Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv , 69978,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"issue":"12","key":"2026080709562184400_ref1","doi-asserted-by":"publisher","first-page":"2464","DOI":"10.1038\/s41591-022-02082-w","article-title":"The context, science and practice of gender-affirming care","volume":"28","author":"Keuroghlian","year":"2022","journal-title":"Nat Med"},{"issue":"5","key":"2026080709562184400_ref2","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1038\/s41585-022-00705-y","article-title":"Principles and outcomes of gender-affirming vaginoplasty","volume":"20","author":"Morrison","year":"2023","journal-title":"Nat Rev Urol"},{"issue":"4","key":"2026080709562184400_ref3","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1016\/j.jsxm.2016.02.001","article-title":"Prevalence of transgender depends on the \u2018case\u2019 definition: a systematic review","volume":"13","author":"Collin","year":"2016","journal-title":"J Sex Med"},{"key":"2026080709562184400_ref4","volume-title":"Canada is the first country to provide census data on transgender and non-binary people."},{"issue":"8","key":"2026080709562184400_ref5","doi-asserted-by":"publisher","first-page":"e2330348","DOI":"10.1001\/jamanetworkopen.2023.30348","article-title":"National estimates of gender-affirming surgery in the US","volume":"6","author":"Wright","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"1-2","key":"2026080709562184400_ref6","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1080\/19419899.2019.1660705","article-title":"The cost of being transgender: where socio-economic status, global health care systems, and gender identity intersect","volume":"11","author":"Koch","year":"2020","journal-title":"Psychol Sex"},{"issue":"1","key":"2026080709562184400_ref7","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1097\/SAP.0000000000004161","article-title":"Transgender healthcare: a historical narrative of gender-affirming plastic surgery","volume":"94","author":"Sparks","year":"2025","journal-title":"Ann Plast Surg"},{"issue":"3","key":"2026080709562184400_ref8","doi-asserted-by":"publisher","first-page":"e3510","DOI":"10.1097\/GOX.0000000000003510","article-title":"Complications and patient-reported outcomes in Transfemale vaginoplasty: an updated systematic review and meta-analysis","volume":"9","author":"Bustos","year":"2021","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"1","key":"2026080709562184400_ref9","doi-asserted-by":"publisher","first-page":"e67","DOI":"10.1097\/SLA.0000000000004717","article-title":"Gender affirming surgery: a comprehensive, systematic review of all peer-reviewed literature and methods of assessing patient-centered outcomes (part 2: genital reconstruction)","volume":"275","author":"Oles","year":"2022","journal-title":"Ann Surg"},{"issue":"6","key":"2026080709562184400_ref10","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1111\/jsm.12868","article-title":"Outcome of vaginoplasty in male-to-female transgenders: a systematic review of surgical techniques","volume":"12","author":"Horbach","year":"2015","journal-title":"J Sex Med"},{"issue":"12","key":"2026080709562184400_ref11","doi-asserted-by":"publisher","first-page":"3580","DOI":"10.3390\/jcm13123580","article-title":"Gender-affirming surgery in low- and middle-income countries: a systematic review","volume":"13","author":"Shah","year":"2024","journal-title":"J Clin Med"},{"issue":"3","key":"2026080709562184400_ref12","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1097\/MOU.0000000000001262","article-title":"Patient-reported outcomes in genital gender-affirming surgery","volume":"35","author":"Odeluga","year":"2025","journal-title":"Curr Opin Urol"},{"issue":"1","key":"2026080709562184400_ref13","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1186\/s41687-024-00785-x","article-title":"International study to develop a patient-reported outcome measure to evaluate outcomes of gender-affirming care - the GENDER-Q","volume":"8","author":"Kaur","year":"2024","journal-title":"J Patient Rep Outcomes"},{"issue":"1","key":"2026080709562184400_ref14","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1186\/s12889-024-21261-7","article-title":"The AFFIRM framework for gender-affirming care: qualitative findings from the transgender and gender diverse health equity study","volume":"25","author":"Quint","year":"2025","journal-title":"BMC Public Health"},{"issue":"6","key":"2026080709562184400_ref15","doi-asserted-by":"publisher","first-page":"1551","DOI":"10.1016\/S0002-9378(03)00932-3","article-title":"Patient-selected goals: a new perspective on surgical outcome","volume":"189","author":"Elkadry","year":"2003","journal-title":"Am J Obstet Gynecol"},{"issue":"1","key":"2026080709562184400_ref16","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.sxmr.2021.04.001","article-title":"Sexual functioning of transgender females post-vaginoplasty: evaluation, outcomes and treatment strategies for sexual dysfunction","volume":"10","author":"Schardein","year":"2022","journal-title":"Sex Med Rev"},{"issue":"4","key":"2026080709562184400_ref17","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1891\/LGBTQ-2021-0041","article-title":"Sexual function and sexual satisfaction following gender-affirming genital surgery: a scoping review","volume":"3","author":"Sampson","year":"2022","journal-title":"Ann LGBTQ Public Popul Health"},{"issue":"1","key":"2026080709562184400_ref18","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1111\/j.1743-6109.2010.02071.x","article-title":"The female genital self-image scale (FGSIS): results from a nationally representative probability sample of women in the United States","volume":"8","author":"Herbenick","year":"2011","journal-title":"J Sex Med"},{"issue":"6","key":"2026080709562184400_ref19","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1097\/JU.0000000000002141","article-title":"Development and validation of urological and appearance domains of the post-affirming surgery form and function individual reporting measure (AFFIRM) for transwomen following genital surgery","volume":"206","author":"Huber","year":"2021","journal-title":"J Urol"},{"issue":"9","key":"2026080709562184400_ref20","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"issue":"3","key":"2026080709562184400_ref21","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1097\/AOG.0b013e3181b2b1ae","article-title":"Defining success after surgery for pelvic organ prolapse","volume":"114","author":"Barber","year":"2009","journal-title":"Obstet Gynecol"},{"issue":"1","key":"2026080709562184400_ref22","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1007\/s00266-017-1003-z","article-title":"Male-to-female sex reassignment surgery using the combined vaginoplasty technique: satisfaction of transgender patients with aesthetic, functional, and sexual outcomes","volume":"42","author":"Zavlin","year":"2018","journal-title":"Aesth Plast Surg"},{"issue":"6","key":"2026080709562184400_ref23","doi-asserted-by":"publisher","first-page":"1744","DOI":"10.1111\/andr.13022","article-title":"Sexual health after vaginoplasty: a systematic review","volume":"9","author":"Kloer","year":"2021","journal-title":"Andrology"},{"issue":"2","key":"2026080709562184400_ref24","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1038\/s41443-022-00529-9","article-title":"The assessment of sexual wellbeing in treatment-seeking transgender individuals: a systematic review of the medical literature","volume":"35","author":"\u00d6zer","year":"2023","journal-title":"Int J Impot Res"},{"issue":"1","key":"2026080709562184400_ref25","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1097\/JU.0000000000000791","article-title":"Operated male-to-female sexual function index: validity of the first questionnaire developed to assess sexual function after male-to-female gender affirming surgery","volume":"204","author":"Vedovo","year":"2020","journal-title":"J Urol"},{"issue":"5","key":"2026080709562184400_ref26","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1080\/0092623X.2013.772550","article-title":"Sexual behavior of gender-dysphoric individuals before gender-confirming interventions: a European multicenter study","volume":"40","author":"Cerwenka","year":"2014","journal-title":"J Sex Marital Ther"},{"issue":"12","key":"2026080709562184400_ref27","doi-asserted-by":"publisher","first-page":"2018","DOI":"10.1016\/j.jsxm.2019.09.003","article-title":"Prevalence of sexual dysfunctions in transgender persons: results from the ENIGI follow-up study","volume":"16","author":"Kerckhof","year":"2019","journal-title":"J Sex Med"},{"issue":"3","key":"2026080709562184400_ref28","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1080\/0092623X.2023.2300828","article-title":"Trans, gender non-conforming and non-binary individuals\u2019 perspectives on experienced sexuality during medical transition","volume":"50","author":"Ross","year":"2024","journal-title":"J Sex Marital Ther"},{"key":"2026080709562184400_ref29","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/9037979","article-title":"Sexuality after male-to-female gender affirmation surgery","author":"Hess","year":"2018","journal-title":"Biomed Res Int"},{"issue":"2","key":"2026080709562184400_ref30","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1007\/s13669-024-00390-1","article-title":"Sexual function after gender affirming surgery","volume":"13","author":"Sahmoud","year":"2024","journal-title":"Curr Obstet Gynecol Rep"},{"issue":"3","key":"2026080709562184400_ref31","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1016\/j.cps.2018.04.002","article-title":"Sexual function after shallow and full-depth vaginoplasty: challenges, clinical findings, and treatment strategies- urologic perspectives","volume":"45","author":"Garcia","year":"2018","journal-title":"Clin Plast Surg"},{"issue":"7","key":"2026080709562184400_ref32","doi-asserted-by":"publisher","first-page":"1626","DOI":"10.1111\/jsm.12914","article-title":"Aesthetic and functional outcomes of neovaginoplasty using penile skin in male-to-female transsexuals","volume":"12","author":"Buncamper","year":"2015","journal-title":"J Sex Med"},{"issue":"6","key":"2026080709562184400_ref33","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1007\/s10508-006-9104-9","article-title":"Patient-reported complications and functional outcomes of male-to-female sex reassignment surgery","volume":"35","author":"Lawrence","year":"2006","journal-title":"Arch Sex Behav"},{"issue":"2","key":"2026080709562184400_ref34","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1007\/s11884-022-00648-5","article-title":"Lower urinary tract symptoms after vaginoplasty: a review","volume":"17","author":"Kreines","year":"2022","journal-title":"Curr Bladder Dysfunct Rep"},{"issue":"2","key":"2026080709562184400_ref35","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/j.ejogrb.2006.03.019","article-title":"Do transsexuals have micturition disorders?","volume":"131","author":"Kuhn","year":"2007","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"3-4","key":"2026080709562184400_ref36","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1080\/09540261.2022.2093629","article-title":"Mental health in transgender individuals: a systematic review","volume":"34","author":"Pinna","year":"2022","journal-title":"Int Rev Psychiatry"},{"issue":"7","key":"2026080709562184400_ref37","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1001\/jamasurg.2021.0952","article-title":"Association between gender-affirming surgeries and mental health outcomes","volume":"156","author":"Almazan","year":"2021","journal-title":"JAMA Surg"},{"issue":"sup1","key":"2026080709562184400_ref38","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1080\/26895269.2022.2100644","article-title":"Standards of care for the health of transgender and gender diverse people, version 8","volume":"23","author":"Coleman","year":"2022","journal-title":"Int J Transgender Health"},{"issue":"6","key":"2026080709562184400_ref39","doi-asserted-by":"publisher","first-page":"1808","DOI":"10.1111\/andr.12884","article-title":"Long-term effect of gender-affirming hormone treatment on depression and anxiety symptoms in transgender people: a prospective cohort study","volume":"9","author":"Aldridge","year":"2021","journal-title":"Andrology"},{"issue":"1","key":"2026080709562184400_ref40","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1186\/s12889-015-1867-2","article-title":"Intervenable factors associated with suicide risk in transgender persons: a respondent driven sampling study in Ontario","volume":"15","author":"Bauer","year":"2015","journal-title":"Canada BMC Public Health"},{"issue":"4","key":"2026080709562184400_ref41","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1093\/jsxmed\/qdaf026","article-title":"Examining gender-specific mental health risks after gender-affirming surgery: a national database study","volume":"22","author":"Lewis","year":"2025","journal-title":"J Sex Med"},{"issue":"1","key":"2026080709562184400_ref42","doi-asserted-by":"publisher","first-page":"qfaf011","DOI":"10.1093\/sexmed\/qfaf011","article-title":"Sexual satisfaction and function (SatisFunction) survey post-vaginoplasty for transgender and gender diverse individuals: preliminary development and content validity for future clinical use","volume":"13","author":"Sahmoud","year":"2025","journal-title":"Sex Med"}],"container-title":["The Journal of Sexual Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/23\/9\/qdag236\/70530154\/qdag236.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/23\/9\/qdag236\/70530154\/qdag236.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T13:56:28Z","timestamp":1786110988000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jsm\/article\/doi\/10.1093\/jsxmed\/qdag236\/8754040"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,5]]},"references-count":42,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,8,5]]}},"URL":"https:\/\/doi.org\/10.1093\/jsxmed\/qdag236","relation":{},"ISSN":["1743-6095","1743-6109"],"issn-type":[{"value":"1743-6095","type":"print"},{"value":"1743-6109","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,8,5]]},"article-number":"qdag236"}}