Vaginoplasty

i don’t watch the TLC  program about Jazz growing up. Not because she isn’t a bright lovely person but because as a transperson with her own lived experience and plenty of others stories read, the desire to add one more just isn’t there.

Still, I knew from ads on TLC that the new season started with her pursuing SRS, which is now appropriate. My sister and a work gf had a few questions and I thought I’d do a public service by explaining the medicine as well as I can as a non doctor.

I’m not going to describe the surgery itself. It’s a messy business. Rather what goes where and how that gets effected for kids on puberty blockers.

vaginoplasty_grafts-e1499070088301.png
Correspondences between male and neo-female anatomy

The diagram above shows the correspondences. Aside from the vagina, for which there is no direct readymade analog on a male body, for the other areas there are tissues that have the same embrioligical origin.

The scrotum, shown in yellow,  is divided and used to lengthen the neovagina and the remainder becomes the labia major.

The majority of the penile skin, shown in pink, lines the neovagina with the remainder becoming the labia minora and clitoral hood.

The most sensitive portion of the glans, purple, becomes the neoclitorus.

A section of urethra, blue, is split and lines the vaginal vault with mucus membrane,

People like myself who are in HRT for a couple of years or longer can have shrinkage  making it more difficult to complete every aspect in the most ideal way.

For kids who are now put on puberty blockers, the avoid the down sides if puberty such as growing a beard or a voice change, but because puberty doesn’t occur, their genitalia are still child sized.

For cases like these there are two approaches. Excise a skin graft from a hairless potion if the body such as the inner thigh or use a section of sphygmoid colon. Each has its good and bad points, but that definitely strays beyong my knowledge.

Long term,  perhaps in five or ten years, a lab grown vagina will be used. At this point is has only been done a few times with girls suffering from a rare disorder that causes the vagina not to form as part of a study. It was successful.

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