Table 3.

Significant participants’ quotes on the effects of surgery on sexual satisfaction

Theme	Contributing to dissatisfaction	Contributing to satisfaction
Tactile sensitivity	Due to less feeling in that area, touch is not always pleasant: I can hardly feel light touch.	I have sensation in the entire neo-phallus: Sensation in neo-phallus is not a requirement.
Erotic sensations	It is harder to get an orgasm. Sometimes I can't orgasm: The erotic feeling is less than before the operation: I was not aware of having a buried clitoris after surgery, which makes it more difficult to stimulate.	I'm able to get an orgasm: I'm glad the erotic feeling is still the same as before the operation.
Functionality	I can't get an erection: I can't have penetrative sex because my neo-phallus is too flexible: It does not meet my preoperative expectations.	I'm able to get an orgasm: I'm able to penetrate: I have accepted the way I am.
Aesthetics	I'm not where I want to be yet. I still want an erection prosthesis, coronaplasty and testicle prostheses. My erotic experience would then increase and it would benefit the arousal: I'm not satisfied with appearance, it's like a limp sausage.	I'm satisfied the way it is: I have accepted the way it is.
Self-image	It is not yet the way it should be; It does not meet my preoperative expectations; My neophallus is not ready yet.	Having a neo-phallus improved my self-image; The operation gave a total reduction of gender dysphoric feelings; I do love myself now; I'm the person I want to be.