Inflammation in the Neovaginal Microenvironment of Transfeminine Individuals
Abstract
Transfeminine individuals are assigned male at birth but do not identify as male. Some transfeminine individuals may choose to undergo the gender affirming surgery vaginoplasty to create a neovagina. There is a paucity of data on the neovaginal microenvironment to inform best gynecological practices. Vaginal and penile inflammation is modulated by local microbiota, but drivers of inflammation in the neovagina are poorly understood. The compositions of the neovaginal microbiota and immune milieu were elucidated from neovaginal swabs, using 16s rRNA gene sequencing and multiplex immunoassay, respectively. Immune data reduction and clustering was performed, and six unique immune profile types (IPTs) were found. Associations between IPTs and bacterial taxa were assessed using regression models. Streptococcus, Atopobium deltea, and Prevotella buccalis all trended toward significant associations with a proinflammatory IPT, however these associations were not statistically significant. Understanding the unique interplay between the neovaginal immune milieu and microbiota will inform trans-specific healthcare.