Reproductive: Transgender

Question 1

What are the two main types of vaginoplasty?

Answer 1

• Penoscrotal inversion (most common, least complications)
• Intestinal interposition (usually done if nor enough penile tissue is available)

Question 2

What are the two main types of bottom surgery for transgender males?

Answer 2

• Phalloplasty (vaginectomy and urethroplasty with creation of a neophallus using skin flaps)
• Metoidioplasty (hormone-induced hypertrophy of the clitoris followed by anastomosis of the urethra to the clitoris, then using the labia minora to create a penile shaft)

Question 3

Which segment of bowel is most often used for intestinal interposition vaginoplasty?

Answer 3

Usually rectosigmoid colon

Question 4

Scrotoplasty

Answer 4

The creation of a scrotum with testicular prostheses (usually silicone) during gender affirming surgery

Question 5

Fistulization between what was a common complication of phalloplasty before modern techniques?

Answer 5

Fistula formation between the neourethra and native vagina (common before it became common practice to resect the native vagina during phalloplasty)

Question 6

What head and neck surgeries are commonly performed as part of feminization during gender-affirming surgery?

Answer 6

• Thyroid chrondroplasty/tracheal shave (gets rid of Adams apple)
• Glottoplasty/cricothyroid approximation (makes the voice sound more feminine)
• Facial feminization