There was a post on ASTFxx's Twitter where a woman learning genecology reported that 20% of the curricula was focused on transwomen. Not menopause, not the uterus, not the intricate functions of female anatomy...but transwomen, aka male people, with their male bodies.
Fun fact, Erin: your neovagina has the same microbiome as an uncircumcised penis:
Conclusions
Penile skin-lined neovaginas have diverse, polymicrobial communities that show similarities in composition to uncircumcised penises and host responses to cis vaginas with bacterial vaginosis (BV) including increased immune activation pathways and decreased epithelial barrier function. Developing a better understanding of microbiome-associated inflammation in the neovaginal environment will be important for improving our knowledge of neovaginal health.
Their neovaginas also have the same bacterial colonies as a woman with bacterial vaginosis. So affirming. They also have the same bacterial colonies in their neovag as they do in their rectum:
Results
Metaproteomics was performed on secretions collected from the neovaginas (n = 5) and rectums (n = 7) of TW surgically reassigned via penile inversion/scrotal graft with (n = 1) or without (n = 4) a sigmoid colon graft extension and compared with secretions from cis vaginas (n = 32). We identified 541 unique bacterial proteins from 38 taxa. The most abundant taxa in the neovaginas were Porphyromonas (30.2%), Peptostreptococcus (9.2%), Prevotella (9.0%), Mobiluncus (8.0%), and Jonquetella (7.2%), while cis vaginas were primarily Lactobacillus and Gardnerella. Rectal samples were mainly composed of Prevotella and Roseburia. Neovaginas (median Shannon’s H index = 1.33) had higher alpha diversity compared to cis vaginas (Shannon’s H = 0.35) (p = 7.2E−3, Mann-Whitney U test) and were more similar to the non-Lactobacillus dominant/polymicrobial cis vaginas based on beta diversity (perMANOVA, p = 0.001, r2 = 0.342). In comparison to cis vaginas, toll-like receptor response, amino acid, and short-chain fatty acid metabolic pathways were increased (p < 0.01), while keratinization and cornification proteins were decreased (p < 0.001) in the neovaginal proteome.
From
here.
The paper he is referencing on how his neovagina totally resembles normal vaginas comes from a paper that bunched natal women with DSDs in with troons. That paper is found
here.
3.1 | General characteristics Patient characteristics and cytological findings are summarised in Table 1. Twenty patients with cytological samples from neovaginas (n=20) were identified. The age at diagnosis ranged from 23 to 68 years with a mean age of 44.312.0 years. The indication for vaginoplasty was GD in 12 patients (60%, 12/20), MRKHS in four patients (20%, 4/20) and DSD in three patients (15%, 3/20), including two with CAH/AGS and one with CAIS. One female (5%, 1/20) underwent vaginal reconstruction after radical resection for vaginal squamous cell carcinoma 3 years prior. Different operative techniques were used in the study population: three patients (15%, 3/ 20) were treated with sigmoid colon transplants, eight patients (40%, 8/20) with non-genital skin grafts and nine patients (45%, 9/20) with the penile/scrotal skin-lined technique. The mean time elapsed since vaginoplasty ranged from 4.8 to 29 years with an average interval of 11.67.9 years. The majority of patients (65%, 13/20) were taking ERT at the time of diagnosis.
This is a case of Tony reading the results, and not what the actual paper says:
Nucleated squamous cells were present in 70% (14/20) of the cytological samples. Two specimens (10%, 2/20) showed all three types of squamous cells (superficial, intermediate and parabasal cells), five specimens (25%, 5/20) had exclusively superficial and intermediate squamous cells, and seven specimens (35%, 7/20) contained only superficial squamous cells. Interestingly, one bowel neovagina, created after vaginectomy for vaginal cancer, contained both nucleated squamous cells from the three epithelial layers and columnar cells (a finding which was interpreted as squamous metaplasia or squamous cells originating from the remaining lower vaginal portion), whereas the other two cases of bowel neovaginas (10%, 2/20) had only (nucleated) columnar cells (Figure 1A–C). The cytological samples from the remaining four penile skin-lined neovaginas (20%, 4/20) exclusively contained desquamated, poorly preserved, anucleated squamous cells (Figure 2) and were considered unsatisfactory as per the Bethesda criteria for adequacy.12,13 No correlation was found between the presence of any nucleated (squamous and/or columnar) cells and the use of oestrogens (P=.101), but the correlation between the presence of nucleated squamous cells and ERT was significant (P=.032). Doderlein bacilli € were found in 20% (4/20) of samples, and 10% (2/20) had a combination of Doderlein bacilli along with the three types of squamous epithelial cells.
A troon with SRS, mistakenly called female, develops a lesion 23 years after getting the snip.
The cytological sample of a 43-year-old female diagnosed with HSIL, who presented with vaginal bleeding and a painful mass at the introitus 23 years after penile/scrotal skin vaginoplasty for SRS, displayed syncytial clusters of cells with large pleomorphic, hyperchromatic nuclei and scant cytoplasm (Figure 3A–C) as well as cells with a koilocytic appearance. HPV testing proved to be positive for HRHPV type 16. HSIL with the transition into invasive carcinoma was verified on subsequent biopsy samples (Figure 3D), and magnetic resonance imaging (MRI) revealed a beginning infiltration...
The penile-inversion technique involves a lot of HPV:
0 Persistent HPV infection is often observed in neovaginas created with the inverted penile/scrotal skin technique as a result of the high prevalence of HPV DNA in male genital sites (28% in foreskin samples, 24% in penile shaft and 16% in glans31) and in the male population in general (up to 76% depending on the genital site, the population tested, the sampling method and the sensitivity of the assay used for detection of the HPV DNA.9 )
The cells transferred into the neovagina among troons retains the same skin cells as the penis:
While a certain amount of anucleated squamous cells is commonly encountered in normal cervical/vaginal smears as a result of chronic irritation, inflammation, cauterisation, pessary usage or uterine prolapse, the presence of abundant anucleated squamous cells is a constant finding of cytological samples from (penile) skin-lined neovaginas. In (penile) skin-lined neovaginas there is usually a considerable amount of cellular debris and sebaceous matter9 because the transplanted tissue reportedly retains certain characteristics of the original skin such as keratinisation and the presence of sebaceous glands.
Most of the cellular samples were not adequate or degenerated:
On the other hand, bowel neovaginas may contain abundant covering mucus. Consequently, cytological samples from (penile) skin-lined neovaginas may display only degenerated material, and cells from bowel neovaginas may extensively be covered by mucus, rendering specimens unsatisfactory. These findings raise questions under which circumstances cytological samples from neovaginas should be designated as unsatisfactory owing to the preponderance of anucleated keratinising squamous cells and/or obscuring factors. According to the 2014 Bethesda classification,12,13 an adequate conventional cervical specimen should contain an estimated minimum of 8000-12000 well-preserved and well-visualised squamous epithelial cells. A lower threshold for liquidbased preparations is a minimum cellularity of 5000 cells.12,13
The conclusion is NOT what Tony says it is:
The present study provides direct evidence that although neovaginal cytology resembles the cytology of the normal vagina only in a minority of cases, patients with neovaginas are prone to precancerous lesions and invasive carcinoma of the neovagina and should, therefore, be advised to engage in cancer screening programmes.
It should be noted that some of the samples with neovaginas here are a
ctual women with DSDs, as seen in the chart. The fact males are also included for
precancerous lesions is not proof they have the same cytology as natal women.
He took
minority of cases - which applied to THOSE WITH AN ACTUAL CERVIX - and assumed that was for all transwomen. He did not read the fucking paper, and it shows. It states in the paper that penile-neovaginas had unsatisfactory levels and still developed lesions, and has the same keratogenesis as a normal penis. Whodathunkit.
it would be based if it wasn’t so obvious that Tony has a hairball up his own neo-china causing him to throw this little hissy fit.
