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Billings et al. Plast Aesthet Res. 2025;12:27 Plastic and
DOI: 10.20517/2347-9264.2025.52
Aesthetic Research

Review Open Access

Sexual health outcomes of non-facial gender-
affirming surgery: a narrative review

1
Harris M. Billings , Elizabeth R. Boskey 2
1
Department of Pediatrics, Boston Children’s Hospital, Boston, MA 02115, USA.
2
Division of Gynecology, Boston Children’s Hospital, Boston, MA 02115, USA.
Correspondence to: Dr. Elizabeth R. Boskey, Division of Gynecology, Boston Children’s Hospital, 300 Longwood Ave., Boston,
MA 02115, USA. E-mail: Elizabeth.boskey@childrens.harvard.edu
How to cite this article: Billings HM, Boskey ER. Sexual health outcomes of non-facial gender-affirming surgery: a narrative
review. Plast Aesthet Res. 2025;12:27. https://dx.doi.org/10.20517/2347-9264.2025.52

Received: 4 Jun 2025 First Decision: 11 Jul 2025 Revised: 24 Jul 2025 Accepted: 18 Aug 2025 Published: 28 Aug 2025
Academic Editor: Gennaro Selvaggi Copy Editor: Ting-Ting Hu Production Editor: Ting-Ting Hu

Abstract
For many individuals, sexual health is an important part of overall health and well-being, yet it remains an
overlooked aspect of care for transgender and gender diverse (TGD) patients. While cisgender and TGD
individuals share many sexual health needs, TGD patients face unique clinical considerations that physicians -
particularly surgeons - must understand in the context of gender-affirming surgery (GAS). As demand for GAS
grows, it is essential that plastic surgeons and other surgical specialists recognize how these procedures affect
sexual health, sexual function, and satisfaction. This review summarizes current evidence on sexual health
outcomes in TGD populations following commonly performed GASs, including chest masculinization, breast
augmentation, phalloplasty, metoidioplasty, vaginoplasty, and vulvoplasty. These procedures can substantially
enhance quality of life (QOL) by improving body congruence and sexual well-being; however, they may also
introduce anatomical, neurological, or psychosocial challenges that influence sexual health. To ensure that patients
can provide fully informed consent, surgeons must understand these outcomes and communicate them effectively
as part of surgical planning and throughout both pre- and postoperative care.

Keywords: Gender-affirming surgery, transgender health, sexual health, phalloplasty, vaginoplasty, metoidioplasty,
breast augmentation, masculinizing chest surgery

© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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