Gender-Affirming Penile Inversion Vaginoplasty

In recent years, greater acceptance of transgender individuals in society and the inclusion of medical coverage for gender-affirmation surgeries has led to an increasing number of patients seeking gender-affirming vaginoplasty. Since the first descriptions of neovaginal reconstruction for gender affirmation were described in the early and mid-1900s, various techniques and revisions have been introduced. This article provides a brief historical perspective, defines the goals of surgical treatment within a multidisciplinary approach adhering to World Professional Association for Transgender Health standards, and focuses on issues related to what is currently the most common approach to primary neovaginal reconstruction, the penile inversion vaginoplasty.