Sexual health outcomes of non-facial gender-affirming surgery: a narrative review

For many individuals, sexual health is an important part of overall health and well-being, yet it remains an overlooked aspect of care for transgender and gender diverse (TGD) patients. While cisgender and TGD individuals share many sexual health needs, TGD patients face unique clinical considerations that physicians - particularly surgeons - must understand in the context of gender-affirming surgery (GAS). As demand for GAS grows, it is essential that plastic surgeons and other surgical specialists recognize how these procedures affect sexual health, sexual function, and satisfaction. This review summarizes current evidence on sexual health outcomes in TGD populations following commonly performed GASs, including chest masculinization, breast augmentation, phalloplasty, metoidioplasty, vaginoplasty, and vulvoplasty. These procedures can substantially enhance quality of life (QOL) by improving body congruence and sexual well-being; however, they may also introduce anatomical, neurological, or psychosocial challenges that influence sexual health. To ensure that patients can provide fully informed consent, surgeons must understand these outcomes and communicate them effectively as part of surgical planning and throughout both pre- and postoperative care.