The neovaginal microbiome of transgender women post-gender reassignment surgery

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dc.contributor.authorBirse, Kenzie D
dc.contributor.authorKratzer, Kateryna
dc.contributor.authorZuend, Christina F
dc.contributor.authorMutch, Sarah
dc.contributor.authorNoël-Romas, Laura
dc.contributor.authorLamont, Alana
dc.contributor.authorAbou, Max
dc.contributor.authorJalil, Emilia
dc.contributor.authorVeloso, Valdiléa
dc.contributor.authorGrinsztejn, Beatriz
dc.contributor.authorFriedman, Ruth K
dc.contributor.authorBroliden, Kristina
dc.contributor.authorBradley, Frideborg
dc.contributor.authorPoliquin, Vanessa
dc.contributor.authorLi, Fan
dc.contributor.authorYanavich, Carolyn
dc.contributor.authorBurgener, Adam
dc.contributor.authorAldrovandi, Grace
dc.date.accessioned2020-06-01T03:17:24Z
dc.date.issued2020-05-05
dc.date.updated2020-06-01T03:17:24Z
dc.description.abstractAbstract Background Gender reassignment surgery is a procedure some transgender women (TW) undergo for gender-affirming purposes. This often includes the construction of a neovagina using existing penile and scrotal tissue and/or a sigmoid colon graft. There are limited data regarding the composition and function of the neovaginal microbiome representing a major gap in knowledge in neovaginal health. Results Metaproteomics was performed on secretions collected from the neovaginas (n = 5) and rectums (n = 7) of TW surgically reassigned via penile inversion/scrotal graft with (n = 1) or without (n = 4) a sigmoid colon graft extension and compared with secretions from cis vaginas (n = 32). We identified 541 unique bacterial proteins from 38 taxa. The most abundant taxa in the neovaginas were Porphyromonas (30.2%), Peptostreptococcus (9.2%), Prevotella (9.0%), Mobiluncus (8.0%), and Jonquetella (7.2%), while cis vaginas were primarily Lactobacillus and Gardnerella. Rectal samples were mainly composed of Prevotella and Roseburia. Neovaginas (median Shannon’s H index = 1.33) had higher alpha diversity compared to cis vaginas (Shannon’s H = 0.35) (p = 7.2E−3, Mann-Whitney U test) and were more similar to the non-Lactobacillus dominant/polymicrobial cis vaginas based on beta diversity (perMANOVA, p = 0.001, r2 = 0.342). In comparison to cis vaginas, toll-like receptor response, amino acid, and short-chain fatty acid metabolic pathways were increased (p < 0.01), while keratinization and cornification proteins were decreased (p < 0.001) in the neovaginal proteome. Conclusions Penile skin-lined neovaginas have diverse, polymicrobial communities that show similarities in composition to uncircumcised penises and host responses to cis vaginas with bacterial vaginosis (BV) including increased immune activation pathways and decreased epithelial barrier function. Developing a better understanding of microbiome-associated inflammation in the neovaginal environment will be important for improving our knowledge of neovaginal health. Video Abstract
dc.identifier.citationMicrobiome. 2020 May 05;8(1):61
dc.identifier.urihttps://doi.org/10.1186/s40168-020-00804-1
dc.identifier.urihttp://hdl.handle.net/1993/34703
dc.language.rfc3066en
dc.rightsopen accessen_US
dc.rights.holderThe Author(s)
dc.titleThe neovaginal microbiome of transgender women post-gender reassignment surgery
dc.typeJournal Article
local.author.affiliationRady Faculty of Health Sciencesen_US
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