One of the first studies on the side effects of transgender surgery has revealed alarmingly high rates of postoperative pain, pain during intercourse and bladder problems, raising troubling questions for this new frontier of medicine.
A large majority — 81 percent — of those who had surgery on their genitals in the past five years said they experienced pain simply from moving in the weeks and months after going under the knife.
Researchers from the University of Florida and Brooks Rehabilitation, a nonprofit health care organization, found that more than half of transoperative patients endured pain during sex, and nearly a third were unable to control their bladder.
Dr. Meryl Alappattu, a UF professor of physical therapy, said she would publish her report later this year, but released preliminary findings in a private online workshop for DailyMail.com to attend.
Dr. Meryl Alappattu (left), a UF professor of physical therapy, and Dr. Alexandra Hill, a UF expert on pelvic problems, supports trans surgeries despite the drawbacks
DailyMail.com was able to see the first findings of a medical report expected later this year
‘There is a high percentage reporting musculoskeletal pain, difficulty moving and pelvic floor dysfunction,’ said Dr Alappattu, adding that more research is needed in a poorly understood area.
“In terms of getting information on the efficacy of these kinds of treatments…we still have a lot of work to do.”
Surgically altering male and female genitals to match those of the opposite sex – known as vaginoplasties and phalloplasties – are widely regarded as difficult and problematic procedures.
Women transitioning to men may choose to have a penis made from tissue taken from their arms, although this procedure is also complex and the result is still markedly different from a biological penis.
Removing the breasts of female-to-male transitions is easier, but can also lead to pain, infection, and problems such as bursting sutures, especially in overweight patients.
Procedural issues are a hot topic in America’s culture wars, especially those about children.
UF researchers studied 21 trans and non-binary people ages 20 to 70 who had had trans surgeries — mostly mastectomies and vaginoplasties — in the past five years.
81 percent experienced pain in their lower back, groin, pelvis, chest or shoulders in the weeks, months and even years after their procedures, researchers found.
Another 57 percent found intercourse painful.
Meanwhile, 29 percent suffered from urinary incontinence or a frequent and urgent need to go to the bathroom, researchers found.
In total, only a quarter went to a physiotherapist to overcome their problems.
Doctors are only now beginning to understand all the consequences of sex reassignment surgery
Jazz Jennings, a trans YouTube influencer, required a second sex change surgery after an unexpected complication
Jennings’ genital overhaul was more difficult than most because she had been on hormone blockers for so long. In the picture: the influencer before her first surgery
Dr. Alappattu said physical therapy can repair some damage, but more research is needed on recovery times and the long-term effects of trans surgeries.
Dr. Alexandra Hill, a UF expert on pelvic problems, described trans patients as surprised by their lengthy recovery, which in some cases took longer than the 6-8 weeks they had expected.
“Sometimes it takes a lot longer than people originally expected to get back to doing things they enjoy doing,” Dr Hill told the online gathering.
Similarly, many male-to-female transitions who have a neo-vagina made are surprised to find that they have to insert a “dilator” into their canal for up to an hour a day after surgery.
Without using a dilator, which resembles a sex toy, the neo-vagina can gradually shorten in depth, Dr. Hill said. Some trans women have to use them for the rest of their lives.
“That’s something a lot of people don’t realize,” she added.
Sexual operations, such as this one in France, are fraught with difficulties
A study of more than 500 transgender adults by the Washington Post and KFF, a health-focused nonprofit, revealed that surgery was rare
Transmedicine proponents present the surgeries as a compromise, acknowledging the substantial drawbacks, but saying they are vital for people with serious discomforts with their own bodies.
Yet they are rare within the transgender community.
Of the estimated 1.6 million trans and nonbinary Americans ages 13 and older, only 31 percent take sex hormones and 16 percent opt for surgery, according to research from the Washington Post and KFF, a health charity.
Most surgeries are breast removals for female-to-male transitions.
Genital surgeries are rare and controversial. Even the World Professional Association for Transgender Health, which advocates for gender-affirming care worldwide, says procedures should not be attempted on children.
Critics warn that invasive, arduous procedures on young people who are still physically developing can leave them with a lifetime of dysfunction.
A phalloplasty procedure, as described in a medical textbook
Jazz Jennings, a transgender girl, suffered a torn vagina at the age of 16 after undergoing sex reassignment surgery.
Experts warn that young people may not have enough skin on their penis or scrotum to build a so-called neo-vagina.
The problem is even worse in children who have taken puberty blockers because their genitals are even less developed and there is less material for the surgeon to work with.
Gender reassignment surgeries can prevent recipients from experiencing any form of adult sexual pleasure if the surgeries take place before the patient’s genitals are fully formed.
Republicans have been trying to ban gender-affirming drugs and surgeries for children and even some adults this year in about 20 states.