Cis and Trans Clitoral Anatomy

INTRODUCTION: As more patients are under gender-affirming vaginoplasty, it is critical for gynecologists to be familiar with postsurgical anatomy to provide comprehensive and inclusive healthcare. The anatomy of the clitoris and vulva created during vaginoplasty differs from that of cis-gendered individuals. Many transgender patients cite a lack of clinician knowledge as a significant barrier to accessing affirming and competent healthcare. A thorough understanding of trans-vulva anatomy allows gynecologists the ability to offer respectful, competent healthcare, which is crucial for the mental and emotional well-being of transgender patients. Furthermore, recognizing the unique aspects of cis and trans clitoral anatomy and how they affect sensation and function is essential for optimal care. This video aims to address these knowledge gaps. OBJECTIVE: The learning objectives for this video are to 1) describe key anatomical differences between the “cis-clitoris” and the “trans-clitoris”; and 2) compare sensory experience and functional outcomes between the cis-clitoris and the trans-clitoris. METHODS: A comprehensive understanding of postoperative vaginoplasty anatomy begins with familiarity with the procedure itself. This video reviews the basics of steps of vaginoplasty, with a focus on the creation of the trans-clitoris and trans-vulva. It highlights both the similarities and differences in cis-clitoral and trans-clitoral anatomy, with a detailed examination of the neurovascular components that contribute to sensation and function. The final rendition of the video was approved by all authors. RESULTS: The video outlines the steps of vaginoplasty, a key gender-affirming surgery that is increasingly performed. It specifically focuses on the creation of the trans-clitoris and trans-vulva, comparing them with their cisgender counterparts, while also discussing important sensory and functional outcomes. CONCLUSIONS: Gynecologists with a comprehensive understanding of transgender anatomy and function can create safer, high-quality, respectful healthcare environments for transgender patients. Proficiency in the anatomy of the trans-clitoris and trans-vulva is vital for offering a wider spectrum of care and for fostering an affirming, supportive atmosphere for this marginalized population.