Exploring subjective and genital sexual response in transgender women upon addition of low-dose testosterone to feminizing gender-affirming hormone therapy: a feasibility study

Vaginal photoplethysmography can be used to assess changes in neovaginal vasocongestion after testosterone supplementation in transgender women. Explorative analyses suggest promising effects on subjective sexual response and an increase in general neovaginal perfusion. We found no difference in neovaginal vasocongestion after exposure to erotic stimuli before and after testosterone supplementation. Clinical benefit needs to be assessed in a blinded and placebo-controlled trial.