Should You Consider Zero Depth Vaginoplasty?
Vulvoplasty, commonly known as Zero Depth Vaginoplasty (ZDV), is a gender-affirming procedure currently gaining popularity among trans women.
Other common names for this procedure are:
Shallow Depth Vaginoplasty
Minimal Depth Vaginoplasty
Limit Depth Vaginoplasty
Cosmetic Vaginoplasty
No Cavity SRS
and finally, Partial SRS
The procedure includes orchiectomy, penectomy, and the creation of a sensate neo-clitoris, labia minor, and major. All were completed without the creation of a neovagina or vaginal canal.
A woman ends up with a full appearance of the vagina. The only thing missing is the depth canal. This one-staged procedure feminizes the external genitalia without the added recovery and needs for dilation.
If you are still wondering, ZDV looks identical to a vaginoplasty.
The main difference is the functionality, in this case, the absence of a vaginal canal.
When people tell me they are planning on ZDV, I wonder if they have fully considered this procedure's pros and cons.
There is much conversation among gender-affirming surgeons in regard to the ethical considerations of ZDV. Just read Dr. Bower’s Zero Depth Vaginoplasty blog to get her to take on it.
Generally speaking, individuals considering ZDV fall into three categories.
#1 PEOPLE WHO ARE NOT INTERESTED IN VAGINAL INTERCOURSE
Majority of the people fall into the first category.
Those seeking this procedure who are not interested in vaginal intercourse of any kind.
A valid reason to undergo ZDV.
However, as a clinical psychologist with a background in sexuality, I know firsthand that sexuality tends to be fluid.
Meaning, sexual preferences and desires change over time.
Especially as we age and mature.
While a person may be certain not to desire vaginal intercourse at this time, it is highly possible that they may in the future.
#2 PEOPLE WITH MEDICAL CONCERNS
In the second category are individuals whose health issues limit or prohibit the creation of a vaginal canal.
Often, these patients have a history of prostate issues, major rectal injury, congestive heart failure, or radiation.
Note that these individuals often desire a vaginal canal but, due to health issues, cannot get one. Therefore they are not voluntarily choosing ZDV.
#3 PERSONAL PREFERENCES DUE TO AGE
In the third category, we find people at an older age, perhaps people in their seventies and up.
People who are not interested in either penetrative vaginal sex or regiment of dilation.
Again, I’d like to stress the point of sexual fluidity as we age.
As for avoidance of daily dilation, Dr. Bowers notes: “Dilation can be seen as a chore. If this is an issue, ZDV may be right for you. I will say, in the first ZDV I ever performed, that patient came to me one year later—at age 73—saying she had met someone and wished to have a vagina” (Zero Depth Vaginoplasty).
IN THE END, IS ZDV WORTH CONSIDERING?
It seems there are two major reasons for wanting ZDV. No desire for vaginal intercourse and lack of commitment to dilation.
Are these reasons worth potential regret?
Or potential inability to get a depth canal once ZDV has been completed? (Keep in mind not everyone can get a vaginal canal post-ZDV, nor is it an easy procedure to add)
Can one have a depth canal and not engage in penetrative vaginal sex the way many do?
While ZDV may be tempting to some people, it is important to remember that we are not holding a crystal ball. Who we are today is not the same as who we are five, ten, or fifteen years from now.
In addition, there is a lack of medical research looking into long-term regret rates and satisfaction rates of individuals with ZDV.
Is ZDV worth considering? That’s highly subjective. I do think it is an excellent option for some individuals.
Thus, with all the hype surrounding ZDV, carefully consider all the pros and cons and the person you may become.
Most importantly, talk to your surgeon about your options, pros, and cons of various procedures, considering your lifestyle. And if you are considering gender-affirming surgery, check out my gender resource page in the states I am licensed in to find a gender-affirming surgeon in California, Texas, New York, or Florida.
