Validation of a Sexual Function Survey for Transwomen After Vaginoplasty

TL;DR

Researchers validated a new survey to assess sexual function and satisfaction in transwomen after vaginoplasty, ensuring it is reliable and accurate.

Contribution

The study presents the first English-language validated survey for sexual function assessment in transwomen post-vaginoplasty.

Findings

The survey demonstrated high interpretive reliability with 99% concordance between responses and verbal confirmations.

Strong internal consistency was observed across domains like Anatomy (r=0.856) and Arousal (r=0.767).

The survey's eight-factor structure was supported through factor analysis and divergent validity with the Female Sexual Distress Scale.

Abstract

This is a multiphased process of validating the first English-language survey for assessing sexual function after gender-affirming vaginoplasty.

To describe the final validation processes for the final English-language tool to assess sexual function and satisfaction after gender-affirming vaginoplasty.

This was a quantitative and qualitative validation study. The 32-question SatisFunction survey was distributed to 50 individuals after vaginoplasty along with the Female Sexual Distress Scale for divergent validity testing. Thirty of these 50 participants then underwent one-on-one cognitive interviews with a member of the research team. The cognitive interviews assessed the construct validity of the survey questions based on the participants' responses. A Community Advisory Board and content expert team reviewed the results of the cognitive interviews to create a final version to be further tested. The revised survey was then distributed to 100 individuals for final validation.

Cognitive interviews demonstrated 99.0% concordance between participants' survey responses and verbal confirmations, supporting interpretive reliability. Strong internal consistency was observed, with each domain significantly correlating with the total score (eg, Anatomy r=0.856, Arousal r=0.767, Orgasm r=0.748; all P<.001). Expected interdomain relationships were identified, including Arousal and Orgasm (r=0.552, P<.001). Female Sexual Distress Scale–Revised scores correlated negatively with Satisfaction (r=−0.416, P<.001), Desire (r=−0.302, P=.003), Genital Self-Image (r=−0.216, P=.034), and Total SatisFunction Score (r=−0.304, P=.003), supporting divergent validity. Factor analysis supported an eight-factor structure aligning with survey domains.

This survey has now been developed and validated through a seven-phase process incorporating community input, physician/surgeon and psychologist expertise, and correlation to other surveys and can be reliably used clinically and in research.

Figures