Ervin Kocjancic

Aim To explore the impact of body mass index (BMI) on the outcomes of gender‐affirming vaginoplasty. Methods A cohort consisting of all gender‐affirming vaginoplasties in our practice between September 27th, 2018, and September 1st, 2022 were identified, and data were retrospectively collected. Patients were classified as obese if their BMI was ≥30 kg/m 2 at the time of surgery and nonobese if their BMI was <30 kg/m 2 . Complications were assigned a Clavien–Dindo grade and grouped as Grade ≥2 versus Grade ≤1. Patient‐reported functional outcomes of intact erogenous sensation, tactile sensation, ability to achieve penetrative vaginal intercourse, and cosmetic satisfaction were assessed. Results A total of 58 patients with a mean follow‐up time of 6.9 months were included. Seventeen patients (mean BMI = 36.8 kg/m 2 ) were classified as obese and 41 patients (mean BMI = 25.1 kg/m 2 ) were classified as nonobese. No significant differences in outcomes were identified in the obese versus nonobese groups in terms of the incidence of complications. Patient‐reported functional outcomes did not differ significantly between the two groups. Conclusions Similar results can be achieved with gender‐affirming vaginoplasty in obese patients when compared to their nonobese counterparts. Eligibility for this procedure should not be restricted based on BMI alone.