(139) What Penis Size and Glans-shape do Cis and Trans Men and Women Prefer?

Abstract Introduction The ideal length, circumference, and appearance of the penis are important to the self-confidence and body image of most men. To date, only 2 works have assessed preferred erect (but not flaccid) penis length, and only among cis-gender women. No study has evaluated preferred aesthetics--ideal erect and flaccid penile length, or, glans-shape and size preferences among cis-gender and transgender and non-binary individuals. These preference domains are especially important with genital gender-affirming surgery (gGAS) because length and glans-shape are entirely elective and technique-based, and help define neophallus appearance. Lastly, outlining the planned glans shape on a neophallus can be technically challenging, and, to date no publications have reported offering trans men input/choices. Objective 1) To query ideal for flaccid and erect penis length across all individuals, across cis- and transgender identities; 2) Determine specific likes/dislikes among all subjects for 7 different glans-shape examples; and 3) Among men undergoing phalloplasty, creation of glans-shape stencils for use in the OR, as a means to offer patients choice, and, to ensure that the final product aligns with patient’s choice. Methods An anonymous, online survey (QualtricsTM) evaluated glans preferences among 7 realistic prosthetic penis models shown. Participants were queried about their age, sex, gender, sexual orientation, and their ideal flaccid and erect penis length. Stencils were created based on 6 penis models. Subsequently, 7 transmen-subjects were able to choose the most-preferred glans shape and the stencil was applied before glansplasty surgery (Figure 1). Glansplasty results were assessed 12-weeks post-operatively (Figure 1c; E-F). Results 74 participants took the survey, (mean age of 35.3, Range: 23–59). 43/74 (58%) self-identified as men, and 28/74 (38%) identified as men, including 7 trans men (Table 1a). Men reported a mean ideal flaccid and erect length of 4.5 and 6.3-inches, respectively, while women reported a length of 5.2 inches and 6.16-inches, respectively. Women had a wider range of responses for both ideal flaccid and erect penile length (p>0.05) (Table 1b). For glans-shape preference, across all groups (independent of sex or sexuality), the “most-liked” options were A and E, and “most-disliked” were B and D (Figure 2). Among the 7 transmen undergoing glansplasty, 5/7 (71%) chose glans-shape C, and 1/7 (14%) each chose glans-shapes A and E, for their own phallus. Conclusions This is the first study to survey both men and women regarding ideal erect penile length, and the first regarding ideal flaccid penile length and glans-shape preferences. Our data suggests that the ideal erect and flaccid length are longer (within 2SD) than the mean values for cis-men of 5.16-inches and 3.61-inches respectively, (Miles et al., BJUI, 2014) but there is greater variability among women’s responses. Regarding glans-shape, most preferred a more tapered, bullet-like tip for the distal glans and a less prominent glans ridge. Finally, our glansplasty stencils are easy to use, yield excellent aesthetic results, and the option to choose their own glans shape is highly appreciated by patients. Disclosure No.