Vaginoplasty

What is vaginoplasty?

Vaginoplasty is a procedure in which surgeons create a vagina from your existing genital tissue. Vaginoplasty requires a lifetime commitment to aftercare, because women who have a vaginoplasty will have to dilate their vagina regularly to keep it open.

The clinicians in the Center for Gender Surgery at Boston Children's Hospital offer vaginoplasty as a gender affirmation procedure to eligible patients who have been living in their identified gender full time for at least 12 months. Our skilled team includes specialists in plastic surgery, urology, gender management and social work, who work together to provide a full suite of options for transgender teens and young adults.

Gender affirmation surgeries are a group of surgical procedures that some transgender and gender diverse people use to help affirm their gender identity. Vaginoplasty is a type of "bottom surgery" (surgery on the genitals) available to transgender women, or those who identify as transfeminine. It involves the surgical creation of a vagina from your existing genital tissue.

Who is eligible for vaginoplasty?

Surgery is never the first step in a gender transition. It is something that happens after you have already explored social and medical transition options. People who choose to undergo vaginoplasty usually do so after taking other steps in the gender affirmation process, such as taking supplemental hormones. To qualify for vaginoplasty at Boston Children's Hospital, you must be at least 17 years old and meet certain criteria.

What happens during vaginoplasty?

Vaginoplasty is the creation of a vagina and vulva (clitoris, labia minora and labia majora) from your existing genital tissue, including the penis and scrotum. Orchiectomy (surgical removal of the testicles) is often performed at the same time as vaginoplasty but can also be performed at an earlier time in transition.

What happens after vaginoplasty?

Vaginoplasty requires a significant recovery time and ongoing self-care. You should expect to spend about a week in hospital following your surgery and to return for follow-up appointments after you are discharged. Because the healing process can take time, you shouldn't engage in strenuous physical activity or heavy lifting in the first six weeks after vaginoplasty.

You will also likely need to urinate through a catheter for one to two weeks after surgery. Your clinical team will give you detailed instructions on how to care for the catheter, and how to check for signs of infection at the surgical site, such as redness and swelling. You will likely be able to walk around and engage in light activity within a week after surgery, and healed enough to go back to all activities at around six weeks. This surgery has a very long healing process that can take 12 to 18 months.

Unlike other gender affirmation surgeries, vaginoplasty requires a lifetime commitment to aftercare. If you have a vaginoplasty, you will initially have to dilate your vagina multiple times a day to keep it open. Eventually, that can be reduced to several times a week, depending on a variety of factors. Your care team will explain in detail how to do this.