Dr. Ivan Mañero, plastic surgeon and director of IM GENDER, presented to the press the updated study on the patient profile of the IM CLINIC Gender Unit. Under the title “Evolution of Techniques and Patient Profile (2002-2023)”. This work highlights the advances in gender surgery and how early care for trans individuals has driven an evolution in gender-affirming surgery.
Early care for trans people
Early care for trans people
Dr. Ivan Mañero emphasizes the importance of understanding that not all trans individuals choose to undergo surgery.
“Each transition is individual and must be respected,” he comments, highlighting that some trans people feel comfortable with their bodies and do not feel the need to modify any aspect.
Gender transition is a unique and private journey, where each person decides which steps to take at every stage, and this is especially important in the case of minors, who must receive appropriate guidance and emotional support.
First Consultation Before the Age of 25
Over the past 25 years, there has been significant social progress in the care of trans people.
In the early years of the IM CLINIC Gender Unit, most patients were over 35 years old and came either alone or accompanied by a friend. Nowadays, the situation is very different! More than 45% of trans individuals who attend an initial consultation at IM GENDER are under 25 years old and usually come accompanied by family members or loved ones.
This is a very important step for the emotional health of these young people, who feel supported in their transition.
This change in support has allowed younger individuals, even adolescents, to begin their transition under specialist care. The use of puberty blockers, which prevent the development of certain secondary sexual characteristics, has been essential to facilitating transition and improving the self-esteem and emotional health of young trans people.
Changes in Gender-affirming surgery
This early care for trans individuals has also led to modifications in gender surgery techniques, particularly in vaginoplasty.
Penile inversion vaginoplasty, peritoneal flap vaginoplasty and colovaginoplasty
The most notable example is vaginoplasty, the surgical procedure used to create a vagina in trans women. However, when genital development is affected by early hormone treatment, the surgical technique needs to be adapted accordingly.
While penile inversion vaginoplasty was the most common technique two decades ago, today vaginoperitoneal techniques and colovaginoplasty are also available and have become increasingly used alternatives. Colovaginoplasty may be recommended when puberty blockers have prevented the genitals from developing enough tissue for penile inversion. In such cases, using penile inversion could result in insufficient vaginal depth for satisfactory penetrative sex.
Peritoneal flap vaginoplasty, a newer technique, is also gaining significant ground because it can provide good vaginal depth and elasticity, as well as natural moisture that may resemble vaginal lubrication in cis women. This technique uses peritoneal tissue, a very thin, smooth, moist membrane that lines much of the abdominal cavity and covers many of its organs, including the intestines.
Autonomy and participation in surgical decision-making
Another key aspect of the study is the change in how patient participation is approached regarding the choice of surgical technique.
Today, at IM GENDER, greater autonomy is granted to patients, considering their environment, lifestyle, preferences, and decisions.
According to Dr. Ivan Mañero, “at least at IM GENDER, trans individuals now have greater autonomy and participation in choosing the surgical technique that best fits their needs. It is no longer just a decision made by the medical team; the reality and needs of each patient are much more considered.”
Vulvoplasty for trans people
A clear example of greater patient autonomy is the increased demand for vulvoplasty. This surgery creates female genitalia without the need to construct a vaginal canal. The procedure is usually requested by trans women who do not wish to engage in penetrative sexual intercourse but who want their genital appearance consistent with their gender identity.
Demand for this technique has grown over the last five years, and in 2023, vulvoplasty accounted for more than 5% of trans women’s genital surgeries, demonstrating the diversity of needs and desires among transgender individuals.
Do you need more information about gender surgeries? Contact our team and we will answer all your questions.
