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informed discussions about sexuality and health [147,148] . For this training to be effective, it must go beyond the
discreet effects of surgery on sexual function and explore the broader ways in which physical and mental
health, as well as the social environment, contribute to sexual health - not only for TGD individuals but for
the population as a whole [21,149-152] .

DECLARATIONS
Authors’ contributions
Made substantial contributions to the conceptualization, wrote the first draft, and assisted with editing:
Billings HM
Made substantial contributions to the conceptualization and edited and revised the manuscript for
publication: Boskey ER

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
Boskey ER is a Junior Editorial Board member of the journal Plastic and Aesthetic Research. Boskey ER was
not involved in any steps of editorial processing, notably including reviewer selection, manuscript handling,
or decision making. Billings HM declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2025.

REFERENCES
1. World Health Organization. Sexual health. Available from: https://www.who.int/health-topics/sexual-health#tab=tab_1. [Last
accessed on 25 Aug 2025].
2. Özer M, de Kruif AJTCM, Gijs LACL, Kreukels BPC, Mullender MG. Sexual wellbeing according to transgender individuals. Int J
Sex Health. 2023;35:608-24. DOI PubMed PMC
3. Hembree WC, Cohen-Kettenis PT, Gooren L, et al. Endocrine treatment of gender-dysphoric/gender-incongruent persons: an
endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2017;102:3869-903. DOI PubMed
4. Coleman E, Radix AE, Bouman WP, et al. Standards of care for the health of transgender and gender diverse people, version 8. Int J
Transgend Health. 2022;23:S1-259. DOI PubMed PMC
5. Park RH, Liu YT, Samuel A, et al. Long-term outcomes after gender-affirming surgery: 40-year follow-up study. Ann Plast Surg.
2022;89:431-6. DOI PubMed
6. Wernick JA, Busa S, Matouk K, Nicholson J, Janssen A. A systematic review of the psychological benefits of gender-affirming
surgery. Urol Clin North Am. 2019;46:475-86. DOI PubMed
7. Almazan AN, Keuroghlian AS. Association between gender-affirming surgeries and mental health outcomes. JAMA Surg.
2021;156:611-8. DOI PubMed PMC
8. Herman JL, Flores AR, O’Niel KK. How Many Adults and Youth Identify as Transgender in the United States. Available from:
https://williamsinstitute.law.ucla.edu/wp-content/uploads/Trans-Pop-Update-Jun-2022.pdf. [Last accessed on 25 Aug 2025].
9. Rastogi A, Menard L, Miller GH, Cole W, Laurison D, Caballero J, Heng-Lehtinen R. Health and wellbeing: a report of the 2022 U.
S. transgender survey. Available from: https://ustranssurvey.org/download-reports/. [Last accessed on 25 Aug 2025].