Operated Male to Female Sexual Function Index (oMtFSFI): A Study on the Validity of the First Questionnaire Developed to Assess the Sexual Function after Male to Female Gender Affirming Surgery.

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No questionnaire is currently available to evaluate sexual function after male to female (MtF) gender affirming surgery. Such a limit leads to a suboptimal evaluation in post-operative sexual function in these patients. We aimed at developing and validating a new questionnaire, the operated Male to Female Sexual Function Index (oMtFSFI), for assessing sexual function in MtF patients after surgery.A panel of experts in gender dysphoria defined the main content areas to be assessed: genital self-image, desire, arousal, lubrication, orgasm, satisfaction, and sexual pain. After a pre-test on 10 patients, in the main study oMtFSFI was applied to 65 operated MtF patients (oMtFp), recruited in 7 Italian centres, and 57 women. The participants provided self-ratings on on-line oMtFSFI, FSFI, BDI-PC, and SF-36 questionnaires. oMtFp completed oMtFSFI twice, four weeks apart.Principal component analysis performed on self-ratings provided by oMtFp on the oMtFSFI items yielded a 3-domain structure: Sexual Dissatisfaction, Sexual Pain and Genital self-image. The three domains were internally consistent and test-retest reliable. Convergent associations with FSFI scales emerged for Sexual Dissatisfaction and Sexual Pain, but not for Genital Self-image. MtF patients reported lower sexual function levels in comparison with cis-women.The present preliminary results supported reliability and psychometric validity of the oMtFSFI in the assessment of key sexual function domains in transgender women, further revealing that Genital self-image represents an assessment area to be taken into account in MtF patients, in addition to domains which are salient for cis-women as well.

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