Vaginoplasty is a surgical procedure that inverts the penis to create a fully functional neovagina. This is one of the options for feminizing gender affirmation surgery.
There are different techniques for vaginoplasty, depending on your desired outcome and anatomy. The neovagina is a very sensitive part of your body that requires sensitivity, awareness and regular care.
The vulva
The vulva is the external part of the female genitalia. It contains your labia (majora and minora), clitoris, the urethra opening and vestibule, Bartholin’s and Skene’s glands, and anus.
Your vulva is shaped like lips, and it can be engorged with blood during sexual arousal. It is a protective organ, but it also plays an important role in sexual pleasure, dispelling the myth that only internal genitalia provides it.
The vulva has two prominent, hair-bearing folds of skin. The outer ones are called your labia majora, and the inner ones are called your labia minora. Together they form a hood around the clitoris, which is engorged during sexual arousal. The clump of tissue that sits at the front of the clitoris is known as the clitoral hood and frenulum. The hood extends downward, forming the border of the vulva vestibule. It links with the clitoris body, which forms the glans clitoris.
The clitoris
The clitoris is the only part of a woman’s genitalia that’s designed specifically for pleasure. It’s also far larger than most of us realize.
The little hill of erectile tissue that we can see is called the glans clitoris and it’s protected by a hood of skin known as the clitoral hood. It’s packed with nerves and is extremely sensitive to stimulation.
Behind the glans is the body (corpora) of the clitoris, which looks like an upside-down Y. From there, the Y branches into two smaller legs called the crura.
The clitoral bulbs, which look like triangular masses of spongy erectile tissue, are between the crura and vaginal wall. These swell with blood when we’re aroused.
The labia majora
The vulva contains two pairs of skin folds, the outer set called labia majora and the inner pair called labia minora. The latter are small and hairless, and the outer ones are large and covered with strong pubic hair. Together they form the lateral boundaries of the pudendal cleft. They also contain the clitoral hood, the clitoral glans, the urethra opening, Hart’s line and vestibular bulbs.
These are all surrounded by a rich supply of blood vessels, which give the vulva its pink color during sexual arousal. The clitoris is a small protrusion from the vulva, similar to the penis in men, and it is very sensitive to stimulation, causing an orgasm.
The outer labia are covered with a layer of hair and a thick coating of oil. The inner labia are not as hairy and are smaller, but they too have a thicker covering of sebaceous glands.
The labia minora
The outer lips of a transgender vagina are called labia majora, meaning “large lips.” These are fleshy and covered with pubic hair. They sit on top of the mons pubis and extend down either side of the clitoris. They’re sensitive and swell when sexually stimulated.
Inside the labia majora are small, thin folds of skin known as the labia minora. The labia minora lack fatty tissue but are rich in sebaceous glands and highly vascular. The inner surface of the labia minora is coated with a thick, sticky mucous membrane containing specialized cells that secrete a lubricating fluid.
The labia minora surround the opening of the vagina and urethra. They’re surrounded by a network of blood vessels that give them their pink color. During sexual stimulation, the blood vessels become engorged with blood, making the labia minora very sensitive to touch.
The perineum
The perineum is a tiny patch of sensitive skin between your genitals and your anus. It also covers structures inside your body that help you pee, poop and have intercourse.
Your perineum consists of a triangular sheet of dense connective tissue called the perineal membrane. It separates the anal canal from the vaginal opening and the urethra. It has both anatomical and surface borders, which are defined by the precise bony margins of your pubic symphysis anteriorly and the apex of the coccyx posteriorly. A transverse line drawn between the ischial tuberosities divides the perineal surface into two triangular portions: the anterior urogenital perineum and the posterior anal perineum.
In a transgender vagina, the penis is inverted and tucked into a pocket created by the Kegel muscles. In this way, a trans woman can experience the same sensations as a woman whose penis is in her vagina naturally.
The hymen
The hymen is a flap of tissue that lines the vaginal opening. It can be any size and has an opening that’s usually the same size as a finger or a tampon. Without this, it would be impossible for menstrual blood to exit the vagina and tampons couldn’t be inserted.
The idea that the hymen “breaks” during sexual activity is a myth. Generally, the hymen is soft and elastic. It will stretch and tear, but it has no connection to whether someone has sex or not, says Dr. White.
Hymens can be perforate (which means they have multiple openings) or obstructive, meaning they cover the entire vaginal opening like a seal. Obstructive hymens may cause women to have longer periods or have trouble inserting tampons. Some people have septate hymens, which have an extra piece of tissue running down the center of the hymen that creates two smaller openings. These can be tricky to use, but they don’t affect virginity or the ability to have children.
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