Do male-to-female (MtF) transgender individuals retain a clitoris after vaginoplasty?

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Last updated: March 20, 2025View editorial policy

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From the Research

Yes, male-to-female (MtF) transgender individuals typically retain a clitoris after vaginoplasty, as the procedure involves creating a functional clitoris using tissue from the glans penis. The goal of vaginoplasty is to create an aesthetic and functional vulva and vaginal canal that enables receptive intercourse, erogenous clitoral sensation, and a downward-directed urine stream 1. During male-to-female gender affirming surgery, the surgeon uses tissue from the glans penis to construct a functional clitoris, which is designed to preserve erotic sensation, as the penile glans and clitoris are embryologically homologous structures, meaning they develop from the same tissue in early fetal development 1. Some key points to consider include:

  • The size and appearance of the neoclitoris is created to resemble a natal female clitoris, and it is typically positioned anatomically similar to a cisgender woman's clitoris, at the top of the vulva where the labia minora meet.
  • Most patients report some level of erotic sensation in this area after healing is complete, though individual results may vary depending on surgical technique, individual anatomy, and healing factors.
  • The procedure carefully preserves the nerves that provide sensation to this area, allowing for sexual pleasure and orgasm in many patients.
  • According to a recent study, patient quality of life has been shown to improve drastically after vaginoplasty, with overall satisfaction rates of 91% and regret rates of 2% 2. It's worth noting that while complications can occur, such as fistula, stenosis, and tissue necrosis, the overall outcome of vaginoplasty is generally positive, with most patients experiencing significant improvements in their quality of life and sexual function 2. In terms of specific surgical techniques, penile inversion vaginoplasty is the most common method used, although other options such as peritoneal and intestinal vaginoplasty are also available 3, 4. Ultimately, the goal of vaginoplasty is to provide a safe and effective way for MtF transgender individuals to achieve their desired gender identity and improve their overall quality of life.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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