I keep being told othereise, that the redulting "neo-vagina" isn't 'proper' vagina. This site is the only one that gave me a definitive explanation but I would like too see if there are more.

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    $\begingroup$ What is SRS, for those who don't know? $\endgroup$ – kmm May 21 '19 at 21:55
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    $\begingroup$ @kmm, SRS is 'sexual reassignment surgery.' $\endgroup$ – Bruce Kirkpatrick May 22 '19 at 16:43

It's true that the microbiome and microscopic structure of the neovagina are not the same as those of a natal vagina, although explicating this outside of circumstances relating to post-surgical dysfunction or pathology seems unnecessary and a potential source of discrimination. Whether post-surgical outcomes are "proper," as you put it, should be evaluated on the basis of patient satisfaction and nothing else, especially not appraisals of minute features.

The medical care of the neovagina of transgender women: a review, Cornelisse et al. Sexual Health. 2017. Emphasis mine.

Microbiology of the neovagina

When assessing a troublesome discharge or bleeding from a neovagina, it is important to keep in mind that the histology and microflora of the neovagina is different from that found in the natal vagina, and hence the aetiology of vaginal discharge in trans women is different from that of cis women. Premenopausal cis women have a vaginal epithelium constructed of glycogen-rich epithelial cells that support the growth of lactobacilli, these produce lactic acid to maintain an acidic vaginal pH and so help to curb the growth of other commensal bacteria. When this mechanism fails, the resultant bacterial vaginosis is characterised by an overgrowth of Gardnerella vaginalis and other anaerobic vaginal bacteria. Neovaginas are not lined by a glycogen-rich epithelium. The microbiology of neovaginas created by penile infibulation and those created by intestinal grafts are discussed separately below.

These more in-depth discussions of the various microbiomes imparted by different approaches to constructing a neovagina begin on the third page (444) of the linked PDF.

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  • $\begingroup$ I was talking about tissue differentiation. web.archive.org/web/20031125030637/http://www.gendercare.com/… $\endgroup$ – Jacob Blaustein May 24 '19 at 18:13
  • $\begingroup$ “Microscopic structure” and “histology” are synonyms for what you’re referring to as tissue differentiation. The cellular phenotypes in the neovagina are not the same as in a natal vagina — ”Neovaginas are not lined by a glycogen-rich epithelium.” $\endgroup$ – Bruce Kirkpatrick May 24 '19 at 18:16
  • $\begingroup$ According to my link "They are only partially correct, since the normal female vaginal tissue is not truly mucosa either. It is called mucosa only because it lines a body passageway. It contains no mucous-secreting glands (Fawcett, et. al., 1995). That is why lubrication is a transudate phenomenon, the source being dilation of the capillaries that surround the barrel and the subsequent squeezing out of fluid through the vaginal walls, which in normal and artificially constructed vaginas have been shown to be a functioning two-way membrane" Is this true? $\endgroup$ – Jacob Blaustein May 25 '19 at 22:33
  • $\begingroup$ You're asking about mucus production, then, and not tissue differentiation. It's true that lubrication is a transudative phenomenon, but the basal fluid in the neovagina is not the same as in a natal vagina: "The basal fluid in the vagina is in fact not produced from a single source but is a mixture of fluids from...the fallopian tubes, the uterus, the cervix and...the vestibular glands (Bartholin's glands)..." $\endgroup$ – Bruce Kirkpatrick May 25 '19 at 23:24

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