- Vaginoplasty is a word that refers to any surgical procedure done to alter, construct or reconstruct a vagina. This includes surgeries to alter the tightness of the vagina, to construct a vaginal canal due to birth defect or to reconstruct the vagina due to cancer or other trauma. It is most commonly used, however, to describe the procedure of sex reassignment surgery (also known as gender reassignment surgery and gender affirmation surgery), wherein a transgender patient's penis is reconstructed into a vagina.
- In the early 1950s, doctors began experimenting with vaginoplasty by removing a transgender patient's penis and testicles, then waiting for the area to heal and using skin grafts from the thighs or buttocks to construct a vaginal canal. This, however, has several problems including intense scarring and a loss of sexual sensation. As a result, in the late 1950s, French plastic surgeon Dr. Georges Burou significantly improved the procedure by by creating the method of penile inversion that is still used today.
- In most vaginoplasty surgeries done to construct a vagina, the erectile tissue is removed from the penis, and the flap of skin with nerve ending still intact is used to create a cavity in the pelvic tissue, the vagina, and a labia minora and basic external genitalia. The tip of the penis is often used to construct a clitoris, and the urethra must be shortened and repositioned above the new vagina. After healing, vaginoplasty is often followed by labiaplasty surgery, which further defines the outer genitalia.
- Like any surgery, vaginoplasty carries risk of both minor and major complications. Minor complications can include minor infections and bleeding. Major complications can include fistula and a loss of genital sensation, though these are most likely to occur with inexperienced doctors. The most common (though hardly universal) effect of vaginoplasty for those who undergo it, however, is a feeling of relief, new sense of sexual confidence and self, and a lessening of anxiety surrounding genitalia.
- Not all transgender people undergo vaginoplasty, either due to cost or a lack of desire for genital or other surgery. A desire for surgery or ability to undergo it is not the litmus test for whether or not a person is "really" transgender. Nor, contrary to popular belief, does vaginoplasty "make" a transgender person a woman; a transgender woman who undergoes vaginoplasty is already a woman by virtue of personal identification. Further, it is a common misconception that women who undergo vaginoplasty do not have sexual sensation. In the vast majority of cases, this is false, and the woman is able to enjoy a pleasurable sex life complete with arousal and orgasm.
