Many transgender women have a penis turned into a vagina (vaginoplasty) as part of their gender-affirming surgery. This is usually paired with other procedures, such as an orchidectomy and breast augmentation.
A surgeon takes tissue from the scrotum to create a new vaginal canal and labia. The tissue is self-lubricating.
Clitoris
The clitoris is a pea-sized nub of flesh that looks like a wishbone. It’s made of erectile tissue, which means it swells with blood when you’re aroused. That’s why it’s so sensitive.
Your clitoris is located right above the urethra opening (the hole through which you pee) and inside your vagina. It’s protected by a flap of skin called the labia majora, which encircle your inner vaginal lips. A mound of skin called the mons pubis sits above it, atop your pelvic bone.
For trans women who’ve undergone lower gender-affirming surgery, their clitoral area is usually much larger than a non-trans woman’s. This is because the spongy part of the organ is enlarged by a surgical procedure known as an orchidectomy. The neo-penis is not as deep as the original, so many trans women need to use a lot of lubrication for penetrative sex. However, their sensitive spots—called the glans and crura—still exist. Stimulating them during sex can feel great, and sometimes lead to orgasms. But, like the penis, you cannot ejaculate from it.
Labia Majora
Labia majora, or labium majus in Latin, are a pair of thick folds of skin and fatty tissue that extend down either side of the vulva. They are hairless, and their outer surfaces are pigmented and develop pubic hair during puberty. The inner surface is smooth and resembles a mucous membrane, making them moist and sensitive to touch.
They also protect the openings of the vagina and urethra. The lower portion of the labia majora meet below the clitoris and above the perineum, in a area called the posterior commissure. The upper part of the labia majora joins with the clitoral hood at a point known as the frenulum of the labia minora.
If people choose to have sex after an orchidectomy or vaginoplasty, they may need to use lubricant and take additional steps to prevent sexually transmitted infections (STIs). These include regularly testing their blood for the presence of hormones that can lead to pregnancy or infection. They should also consider using a condom during oral-vaginal sex and be sure to use contraception for penetrative sex.
Hymen
The hymen is a thin piece of tissue that seals the entrance to the vagina. It is often seen as proof of a girl’s or woman’s virginity, and it usually breaks during sexual activity.
It’s not clear what exactly the hymen does in our bodies, but it may have something to do with keeping bacteria out of the vagina. Like other tissues in the body, it can stretch and tear over time. Sometimes people don’t even know when their hymen breaks, because it happens slowly over time as they wear down the edges.
Some girls and women have very thick or rigid hymens that don’t have an opening at all. This condition is called a septate hymen, and it can interfere with tampon use and menstrual blood flow. A doctor can make a small hole in the hymen to help it become more flexible, if needed. This is a surgery called a hymenotomy.
Perineum
During a vaginoplasty, surgeons create both outer and inner vaginal linings by using skin from the penis or scrotum. They also use the head of the penis to create a clitoris. In some types of vaginoplasty, hair is removed from the scrotum and penis before surgery to guarantee that the resulting vagina is hair free. In this case, the surgical site needs to be dilated regularly to maintain the proper size and ensure that it is self-lubricating.
Semen flows through a tube called the vas deferens from each testicle. This tube connects to the urethra at a juncture near the prostate. When AMAB people have sex, muscle contractions around the prostate and other glands shoot semen out of the end of the penis. The sperm then travels through the urethra and into the perineum, where it becomes part of a mucous membrane that partly covers the anus. The hymen, which is the inner opening to the anus and urethra, is stretched or broken when tampons, fingers, and other objects are inserted into the vagina.
Vulva
The vulva is the external parts of the female genitalia that are visible between the legs. This includes the glans clitoris, labia minora and majora, the opening of the urethra (the introitus), as well as surrounding tissue.
The main part of the vulva is the mons pubis, which is a mound of tissue above the pubic bones that is prominent in females. It is covered in pubic hair and contains sebaceous glands that secrete lubrication during sexual activity.
Labia minora are the inner lips of the vulva that sit inside the labia majora and closer to the urethra opening. They can vary in size, shape and color from person to person.
The urethra is an extension of the bladder that allows urine to exit the body. It is usually partially covered by the hymen, which is located to the back of the opening of the urethra. The vagina is an elastic, muscular tube that connects to the cervix proximally and extends to the exterior surface through the vulva vestibule distally. It also acts as a reservoir for semen to collect before it ascends into the cervix and enters the fallopian tubes during sexual intercourse.
