Neovaginal chlamydia documented for first time in transgender women
Researchers documented what are believed to be the first reported cases of neovaginal chlamydia in two transgender women who had recently undergone vaginoplasty, according to a recently published report.
“Although chlamydia infections have previously been reported in transgender women, these have all been anal or urethral infections. These are the first published case reports describing neovaginal infection,” Asa E. Radix, MD, MPH, senior director of research and education at the Callen-Lorde Community Health Center in New York, told Infectious Disease News.
According to the report, which was published in Open Forum Infectious Diseases, the cases of Chlamydia trachomatis infection were in transgender women who underwent penile-inversion vaginoplasty with integrated peritoneum and urethral grafts.
The first patient was a 21-year-old, HIV-negative transgender woman who presented with vaginal irritation, discharge and malodor in January 2019, 4 months after her surgery. According to the report, she had several cisgender male sexual partners after surgery and used condoms for anal receptive sex but not for vaginal or oral sex. A urine sample was positive for C. trachomatis.
The second patient was in a 32-year-old, HIV-negative transgender woman who presented for routine asymptomatic STI screening in March 2018. According to researchers, she had undergone a vaginoplasty 5 months before the screening and was postoperatively treated for neovaginal granulation tissue and stress incontinence. According to the report, she had condomless vaginal receptive sex with cisgender men but denied oral or anal sex. Both a urine and a vaginal swab tested positive for C. trachomatis.
Radix and colleagues said the tissue types associated with the integrated peritoneum and urethral grafts may have facilitated the C. trachomatis infection.
“I would not consider this scary,” Radix said. “Transgender women will not have the serious sequelae that can occur in cisgender women, such as pelvic inflammatory disease, infertility and ectopic pregnancy.”
Moving forward, screening and treatment will be important for the patients and to prevent ongoing transmission of infection to sexual partners, he said.
“Clinicians should screen anatomic sites that may be exposed to STIs, including neovaginal screening in transgender women,” Radix said. “The new penile-inversion vaginoplasty procedures that include peritoneal or mucosal grafts may increase susceptibility to STIs, but we still need further research in this area.” – by Caitlyn Stulpin
Disclosure: Radix reports no relevant financial disclosures.