1. A neovagina is not a self-cleaning organ
Unlike a natal vagina—whose muscular walls naturally press together and whose micro-flora keep it healthy—a surgically created cavity is lined with penile or scrotal skin that the body treats as an open wound. Because the tissue was never meant to live inside the body, it cannot rinse itself, regulate moisture, or fight infection. One detransitioned woman found the smell so overpowering that she stopped using public toilets: “I am too ashamed … because of the fog of smell that comes from my infected vagina.” – Whatnowbabe source [citation:6b8a47f5-c11a-4967-a15b-04f4eb0b20f8] Daily washing and antibiotic courses become part of life, yet the risk of chronic infection remains.

2. The cavity has to be forced open for life
Muscles give a natal vagina its stretch and spring; a neovagina is simply a skin pocket the body tries to close. To keep it open, owners must insert a rigid dilator on a strict schedule—often several times a day at first, then several times a week forever. Skip the routine and the opening narrows or seals, requiring painful re-cutting. “Is it worth the pain of dilating every day? … Once it is done there is no return.” – [deleted] source [citation:2e2a33a8-17bf-4c76-9776-f93089ce187e] The timetable can feel like a second job and may limit travel, work, or spontaneous intimacy.

3. Sexual sensation is often reduced or replaced by pain
Nerves are cut, stretched, or buried during surgery, so many people lose the gentle, responsive feeling that once came from the penis or scrotum. What remains can be numbness, tingling, or stinging. One friend told a detransitioned woman that intercourse “feels like stinging in the pocket” and that she now avoids it. – CoraleeRozenbottel source [citation:317e6581-e70a-4bf7-9ed0-3566ad9b8f67] Because the lining is ordinary skin, it does not self-lubricate; friction and small tears are common, making intimacy stressful instead of pleasurable.

4. Serious complications can appear months or years later
Hair-bearing skin grafted inside may continue to grow hair, forming odorous mats or cysts. The wall between rectum and new cavity is thin; a tear can create a fistula that lets stool leak through the vagina. One summary given to a worried man read: “It’s a wound full of bacteria … that may leak faeces, urine and/or digestive fluid.” – DraftCurrent4706 source [citation:c7d450c0-9687-4e83-8529-6b2da0730960] Revision surgeries, bowel repairs, or complete closure may follow, each carrying new risks.

5. Daily life can revolve around hiding, cleaning, and planning
Because the result seldom looks or behaves like natal female genitals, some people schedule their day around dilation, padding for leaks, and timed bathroom trips to avoid public odor. Travel, sport, or even a long workday can become logistical puzzles. After repeated closures and failed repairs, one woman decided the only peaceful path was to ask surgeons to sew the cavity shut and accept the scars: “I think I will ask to close the cavity entirely.” – Whatnowbabe source [citation:6b8a47f5-c11a-4967-a15b-04f4eb0b20f8]

Understanding these realities—lifelong dilation, infection risk, loss of sensation, and possible fistula or closure—can help anyone questioning gender dysphoria weigh whether surgery aligns with their long-term well-being. Relief often begins with non-medical support: talking to a therapist who sees gender distress as a signal, not a sentence; joining others who celebrate gender non-conformity without hormones or knives; and learning that a body does not need surgical alteration to be whole, clean, or loved.