Sexual Quality of Life After Feminizing Genital Gender-Affirming Surgery in Transgender Women: Associations with Psychological Resilience and Body Image

Sexual quality of life after feminizing genital gender-affirming surgery remains insufficiently characterized, particularly regarding psychosocial factors. This single-center retrospective cross-sectional survey examined associations of body image and psychological resilience with sexual quality of life in 39 transgender women after feminizing genital gender-affirming surgery, all sexually active in the preceding month. Sexual quality of life, psychological resilience, and body image were assessed using validated Turkish self-report instruments. Bivariate associations were examined using Spearman correlations, and exploratory ordinary least-squares regression examined the associations of psychological resilience and body image with sexual quality of life; age and postoperative duration were also explored. Psychological resilience was strongly correlated with sexual quality of life (rₛ = 0.900) and body image (rₛ = 0.864), and body image with sexual quality of life (rₛ = 0.764; all p < 0.001). Neither age nor postoperative duration was significantly associated with any measure. Psychological resilience and body image were each strongly associated with postoperative sexual quality of life and were themselves closely interrelated. These findings support considering psychosocial factors within a broader multidimensional assessment of postoperative sexual well-being.