Shallow-depth vaginoplasty: preoperative goals, postoperative satisfaction, and why shallow-depth vaginoplasty should be offered as a standard feminizing genital gender-affirming surgery option.

This article focuses on shallow-depth vaginoplasty (SDV), a feminizing genital gender-affirming surgery option that creates an external vaginal introitus without a vaginal canal, as an alternative to full-depth vaginoplasty (FDV). The study describes a surgical technique for SDV, reports clinical outcomes from 35 patients (32% of 110 undergoing primary feminizing surgery at a single institution), and presents patient-reported decision-making priorities and postoperative satisfaction. Findings indicate that SDV patients often prioritize long-term quality-of-life factors—such as avoiding lifelong vaginal dilation and douching—over short-term surgical risks, and report high satisfaction with appearance, sexual function, and recovery; 86% would choose SDV again. The authors conclude that SDV, associated with fewer complications and reduced postoperative maintenance, should be routinely offered alongside FDV to all patients seeking feminizing genital gender-affirming surgery.