INTRODUCTION: In gender-confirming chest surgery, hardly any study has extensively evaluated the improvement of the sexual well-being of transgender patients after breast augmentation/removal. This prospective study aims to assess the potential improvement of body awareness during sexual intercourse after a chest surgery and compare differences between female-to-male (FtM) and male-to-female (MtF) patients.
MATERIALS AND METHODS: From October 2019 up to August 2020, all transgender patients eligible for gender-confirming chest surgery in our institution were asked to file two questionnaires: BREAST-Q and BESAQ. Different follow-ups were considered: pre-op, 4- and 12-month post-op.
RESULTS: 13 FtM and 10 MtF patients were enrolled. In both FtM and MtF patients, a significant improvement of the psychosocial well-being and patient’s satisfaction with breast/chest aesthetic was found at 4- and 12-month post-op compared with pre-op.
While body awareness during sexual intercourse improved significantly among FtM patients at 4-month post-op, no improvement was observed among MtF patient until 12-month post-op. As no FtM patient underwent phalloplasty during the follow-up, most MtF patients underwent vaginoplasty before the 12-months post-op assessment.
CONCLUSION: Gender-confirming chest surgery brings a noticeable improvement of chest/breast satisfaction and psychosocial well-being at 4-month post-op in both groups. Regarding body awareness during sexual intercourse improvement, differences between FtM and MtF patients were observed depending on the gender-confirming chest surgery: while mastectomy successfully improves sexual well-being of FtM patients, breast augmentation seems to be insufficient in improving MtF patients’ sexual well-being.