Abstract

INTRODUCTION AND OBJECTIVE:

The number of transgender individuals undergoing gender transition related healthcare procedures is growing. Transgender patients who present for medical and surgical care are treated with hormone medications and genital surgeries that affect, and often significantly change, sexual function. While patients rely on providers to counsel them about what effects they might expect, the effects of such treatments on sexual function are not well described or understood. We sought to assess the impact of hormone therapy on patients’ sexual function.

METHODS:

We queried potential changes in orgasm function before and after commencing feminizing hormone therapy (HT) (minimum 1 year) among 126 consecutive transgender women who presented to either undergo initial vaginoplasty surgery (N=63), or who had previously had vaginoplasty (N=63) by a single surgeon (MMG). We queried the following specific domains under a uniform condition (masturbation): 1. Lead-time to achieve orgasm, 2. Duration of orgasm, 3. Body location of orgasm sensation; 4. Description of orgasm as either a single or multiple-peak event, 5. Duration of post-orgasm refractory period, and 6. Overall satisfaction with orgasm quality.

RESULTS:

Patients pre/post-vaginoplasty surgery reported similar changes in orgasm function: increase in lead-time necessary to achieve orgasm, orgasm duration, and overall orgasm satisfaction; and decrease in post-orgasm refractory period. Over half of the patients reported experiencing orgasms in additional body locations. Additionally, prior to commencing HRT, the majority of patients in both pre- and post-vaginoplasty surgery groups reported their orgasms as a short, single-peak event but following HRT these same patients reported longer and multiple-peak orgasms. Reported dissatisfaction was driven by longer time to orgasm.

CONCLUSIONS:

Our findings suggest that, with feminizing hormone therapy, transgender women experience considerable change in several sexual function domains- but also improved overall orgasm quality and satisfaction. Interestingly, HRT results in more orgasm features that more closely resemble those of cis-women, which has not been reported to date. It is important to share such data with patients prospectively.

Source of Funding:

NA