Vulvoplasty

What is a vulvoplasty?

A vulva is made during a vulvoplasty, a gender-affirming procedure. The external genitalia of persons who are born with a feminine gender designation are included in the vulva (DFAB). The mons, clitoris, and outer and inner labia are the parts of a vulva that are created during a vulvoplasty out of tissue that is connected to being born male (DMAB).

A vulvoplasty alters the appearance of the genitalia for many transgender or nonbinary people who are DMAB so that they look more in line with how they see their gender or gender identity. For trans and nonbinary DMAB people who desire to live more comfortably as their true selves, vulvoplasty is just one possibility.

Why are vulvoplasties done?

If your genital appearance makes you uncomfortable, a vulvoplasty may be able to assist. If you’d prefer your genitals to resemble a vulva more, having a vulvoplasty might be the best option for you. A vaginoplasty, a procedure that also produces a vaginal canal, is an option, but a vulvoplasty is less invasive and carries fewer risks. Each person’s gender journey is unique.

Who should have a vulvoplasty?

A vulvoplasty is a significant, irreversible procedure. Because of this, it’s crucial to ensure that your surgery doesn’t impair your physical or mental health. Having a care team that consists of surgeons and behavioural health experts with experience in transgender care can help you determine if a vulvoplasty is the best course of action for you. To make sure you’re a good surgical candidate, they’ll assess your physical and emotional health.

Physical Health Evaluation

Your provider will do a physical evaluation to be sure you’re healthy enough for surgery. Your provider will:

• Review your medical history.
• Conduct a thorough physical exam.
• Order lab tests that show important information about your hormone levels and the health of your organs.
• Note any infections or prior conditions you may have, treating or helping you manage them as needed.
• Ensure that you’re drug-free and smoke-free, offering resources and support as needed.

Your healthcare professional will also discuss with you how having a vulvoplasty would impact your long-term health and family planning objectives. You won’t be able to conceive a child biologically after surgery. You can store your sperm for later use if you desire to start a family in the future.

Behavioral health evaluation

You’ll meet with two different behavioral health specialists, both with expertise in transgender health. They’ll work with you to be sure that having a vulvoplasty is a healthy option for your psychological well-being, too. Topics you discuss may include:

• Your feelings about the disconnect between the way your body looks and your gender identity.
• Your experiences of gender acceptance and discrimination in places where you interact with others — like work, school and at home.
• Your goals for your vulvoplasty, including the support network and resources you have to help you through your surgery, from preparation to recovery.
• Your history with behavioral health conditions or mood disorders.
• Your history with self-harm or other risk-taking activities.

Before your request for a vulvoplasty is granted, both specialists must submit a letter of support. Your compliance with the World Professional Association of Transgender Health (WPATH) standards of care for surgery must be attested in the letters. The letters ought to attest that:

• You’ve been undergoing hormone therapy for at least a year unless there are medical reasons that prevented it.
• You’ve been living in a way that syncs with your gender identity for at least a year.

The third step is to make sure you comprehend the risks, advantages, and costs associated with vulvoplasty. Vulvoplasty costs a lot of money, and not all insurance policies will cover treatment. And you have to agree to the procedure.