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Chapter 33 - The Vaginal and Neovaginal Microbiome under Androgen or Estrogen Exposure Respectively

from Section F - Impact of Gender-affirming Hormonal Therapy on Genital Organs

Published online by Cambridge University Press:  22 December 2022

By
Hans Verstraelen  and
Piet Cools
Edited by
Mick van Trotsenburg ,
Rixt A. C. Luikenaar  and
Maria Cristina Meriggiola
Mick van Trotsenburg
Affiliation:
Sigmund Freud PrivatUniversität, Wien
Rixt A. C. Luikenaar
Affiliation:
Rebirth Health Center, Utah
Maria Cristina Meriggiola
Affiliation:
Università di Bologna
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Summary

A particularly important, yet largely underappreciated, aspect of transgender health relates to the creation of novel microbiome niches with gender-confirmation surgery. In transwomen specifically, gender-confirming surgery may involve the creation of a vault through vaginoplasty [1], open to microbial colonization. In ciswomen, it is rather well established that the vaginal microbiome tends to be dominated by niche-specific Lactobacillus taxa, an ecology understood as central to human reproductive health [2,3]. Perturbations of this community ecology in turn are known to predispose to an array of adverse health conditions, including an overall increased acquisition risk of sexually transmitted infections (STIs). Apart from surgical interventions, transwomen as well as transmen will most often receive gender-affirming hormonal treatment, which may also affect the structure and function of the vaginal as well as of the neovaginal microbiome. In this chapter, we will review what is known of the neovaginal microbiome, as well as the effects of estrogen and androgen exposure on the vaginal and neovaginal microbiome, respectively.

Type
Chapter
Information
Context, Principles and Practice of TransGynecology
Managing Transgender Patients in ObGyn Practice
 , pp. 243 - 249
Publisher: Cambridge University Press
Print publication year: 2022

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References

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