Men commonly boast about and exaggerate their genital dimensions. Some male-to-female transsexuals engage in this kind of behavior after undergoing SRS: "My surgeon gave me six inches of vaginal depth." "Oh yeah? Well, my surgeon gave me seven inches." Sometimes one hears a variation on the same general theme: "My boyfriend is so big that I needed eight inches to accommodate him." And so forth.
Listening to comments like these, some transsexual women may develop unrealistic beliefs and expectations concerning vaginal depth following vaginoplasty. Here are a few observations that transsexual women might want to keep in mind:
Thirty years later, Pendergrass, Reeves, Belovicz, Molter, and White (1996)
found slightly higher numbers. They measured vaginal depth in 39 women, only one
third of whom were nulliparous. They found an average vaginal depth of 11.5 cm
(4-1/2 inches), with a range of 6.8 cm to 14.8 cm (2-3/4 to 6 inches).
Dissection of the vaginal cavity can continue along the rectovaginal septum until the surgeon reaches the peritoneal reflection, sometimes called the Douglas pouch. Typically, the peritoneal reflection is reached at a depth of 10 to 12 cm (4 to 5 inches), according to recent anatomic studies by Giraldo, Mora, Solano, Gonzáles, and Smith-Fernández (2002). Dissection can only be carried farther if there is a deliberate intention to enter the peritoneal cavity, as might be the case during a colon segment vaginoplasty.
I wrote to Dr. Giraldo about this issue, and he replied to me as follows:
"We performed [measurements on] sagital preparations of the pelvis in 2 out of 14 male human cadavers. Measurements of the rectovesical space were 12.5 cm and 10.5 cm. Additionally, I have carefully measured the length of the cavity in my MTF SRS cases (38 in the last 3.5 years). The mean length of this cavity from the perineal skin to the Douglas pouch, without vaginal speculum pressure, was 10 to 12 cm. Both in anatomic and clinical dissections, the surgeon finds a true anatomical stop at the Douglas [pouch]. Only if this anatomic limit is surgically modified would it be possible to obtain larger rectovesical cavities and larger neovaginas (i.e., [when] using intestinal segments). I wholeheartedly agree with you that cutaneous neovaginas more than 12 cm long (i.e., 15 cm) are really difficult to find if a correct and scientific evaluation is carried out. The Amsterdam Gender Team, Hage & Karim, has reported similar mean lengths, 10-12 cm, in many articles."
(F. Giraldo, personal communication, January 30, 2003)
As Dr. Giraldo notes, honest vaginal depths of 15 cm or more are rarely
encountered except with colon segment procedures. Blanchard, Legault, and
Lindsay (1987) found a maximum vaginal depth of 13 cm in their group of 22
patients, while McEwan, Ceber, and Daws (1986) reported that only 3 of their 33
patients (9%) had measured vaginal depths of 15 cm or greater.
Blanchard, R., Legault, S., & Lindsay, W. R. N. (1987) Vaginoplasty outcomes in male-to-female transsexuals. Journal of Sex and Marital Therapy, 13, 265–275.
Giraldo, F., Mora, M. J., Solano, A., Gonzáles, C., & Smith-Fernández, V. (2002). Male perineogenital anatomy and clinical applications in genital reconstructions and male-to-female sex reassignment surgery. Plastic and Reconstructive Surgery, 109, 1301-1310.
Harding, R., & Golombok, S. E. (2002) Test-retest reliability of the measurement of penile dimensions in a sample of gay men. Archives of Sexual Behavior, 31, 351-357.
Masters, W. H., & Johnson, V. E. (1966). Human Sexual Response. Boston: Little, Brown.
McEwan, L., Ceber, S., & Daws, J. (1986). Male-to-female surgical genital reassignment. In W. A. W. Walters & M. W. Ross (Eds.) Transsexualism and Sex Reassignment (pp. 103-112). Melbourne: Oxford University Press.
Pendergrass, P. B., Reeves, C. A., Belovicz, M. W., Molter, D. J., & White, J. H. (1996). The shape and dimensions of the human vagina as seen in three-dimensional vinyl polysiloxane casts. Gynecologic and Obstetric Investigation, 42, 178-182.
Wessells, H., Lue, T. F., & McAninch, J. W. (1996) Penile length in the flaccid and erect states: guidelines for penile augmentation. Journal of Urology, 156, 995-997.
© 2004 by Anne A. Lawrence, M.D., Ph.D. All rights reserved.