A Novel and Validated Survey Explores Quality of Life Outcomes in Transgender Women Following Vaginoplasty

Purpose: Traditionally, there has been little emphasis regarding the self-evaluated experience following gender affirmation surgery (GAS). As such, this study aimed to evaluate patient-reported outcomes following vaginoplasty in transgender individuals using a novel and validated Affirming Surgery Form and Function Individual Reporting Measure (AFFIRM-A). Methods: 279 transgender patients completed the AFFIRM-A survey, reporting on their experiences with feminizing GAS outcomes. Surveys were given to patients via email prior to GAS, at 2 weeks, 6 months, and 12 months postoperatively. Pre and post GAS responses were compared using Wilcoxon signed rank tests. All participants voluntarily completed the same survey using the Vision Tree Platform to eliminate bias. Results: Prior to GAS, ~3% of respondents reported positive feelings about their genitals, ~18% reported comfort with a sexual partner seeing their genitals, ~1% reported the absence of embarrassment regarding their genitals, and ~1% reported that their genitals matched their gender identity. Six months after surgery, the percentages rose to ~85% (p0.001), ~77% (p0.001), 66% (p0.001), and ~85% (p0.001) respectively. Prior to GAS, ~78% of respondents reported they could not dress as desired because of the appearance of their genitals and 83% reported the appearance of their genitals prevented them from doing some enjoyable activities. Six months after surgery, the percentages fell to ~3% (p0.001), and ~7% respectively (p0.001). Conclusion: Gender affirming surgeries like vaginoplasty are associated with dramatic quality of life improvement in transgender people. All six gender identity metrics measured by the validated AFFIRM-A survey showed unequivocal benefits following vaginoplasty.