Intersex individuals-those born with congenital variations in sex characteristics (VSCs)-experience elevated and underrecognized clinical risks. In an analysis of 3.42 million electronic health records, we identified 2,207 intersex patients, of whom 2.95% were diagnosed with gender dysphoria (GD)-nearly four times the rate in the general population (OR = 3.84, p < 0.001). In temporally resolvable cases, GD preceded intersex recognition in 47% of patients. Intersex individuals also received GD...

Efforts to alleviate the psychological distress of gender dysphoria have included the use of exogenous estrogen (often with anti-androgens) to alter secondary sex characteristics of natal males. In response to the rapid increase in presenting cases among young people, extensive scrutiny has now been brought to bear on these medical interventions for minors, with ESCAP reporting "an urgent need for safeguarding clinical, scientific, and ethical standards." However, due to the lack of systematic...

CONCLUSION: RSV is a feasible and safe technique as a primary option for vaginoplasty or as a revision to treat vaginal stenosis. Larger and longer comparative studies are needed to assess the utility and long-term functional outcomes of this technique.

CONCLUSIONS: For TGD people, scar complications, visibility, and permanence represent major concerns. While many TGD people ultimately accept scarring as an unavoidable consequence, scarring both related and unrelated to gender-affirming care can present a significant psychosocial stressor for TGD people. Scarring can result in physical health complications, gender dysphoria, and negative body image; visible scarring is also a barrier for TGD people who wish to blend into society. Clinicians...