"General sexual satisfaction has been shown to improve after initiation of gender affirming care, both medical and surgical. Several studies have shown a decrease in sexual distress after a combination of hormone therapy and gender affirming surgery. Interestingly some studies discussed a difference in sexual satisfaction based on the type of genital reconstruction that was performed, with one study showing an increase in sexual satisfaction for those who received a metoidioplasty compared to those who received a phalloplasty. Gender affirming surgery has shown to increase sexual satisfaction, even when solely analyzing body self image as demonstrated in several studies despite surgical complications."