(FAQ) Colonic vaginoplasty versus penile skin inversion with or without scrotal graft | Dr. Harold Reed

Dear Dr. Reed,  What are your thoughts on colonic vaginoplasty versus penile skin inversion with or without scrotal graft?  Angela

Dear Angela,

In Europe where puberty blocking hormones are used, the male genitalia are very juvenile in size.  There is a paucity of penile and scrotal skin to fashion a neo-vagina. So it is not uncommon to see more oolonic vaginas there.  In Thailand, I have seen transgender vaginoplasty performed with a scrotal graft and the penile skin is used to form the labia minora.  But again for this approach reasonably adult sized penile skin is needed.

Perhaps there are great transgender surgeons doing primarily a colonic vaginoplasty with very aesthetic results but what we’ve seen has not been all that attractive.  Yes, potentially the depth may be deeper if the colon is used because part of the vagina is intra-peritoneal.  That there is more lubrication is debatable, because if this were the case why do doctors put KY jelly on the gloved index finger prior to a rectal exam.  Also not specially thrilled with a somewhat different odor while not fecal, does not seem reminiscent of a natal female vulva.


Harold M. Reed, M.D.
The Reed Centre for Transgender Surgery | Miami

Colonic mucosa is redder than vulvar or vaginal mucosa. See the 3rd photo.

Pejoratively we call the appearance of colonic vaginoplasties “the red stoplight sign.” Perhaps
we can all agree the last comment one wants to hear in an intimate situation is “what’s that?”

red stoplight sign 2

red stoplight sign 1

red stoplight sign 3

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