Gender Affirmation Surgery on the Rise: Analysis of Trends and Outcomes

Chaya, Bachar F.; Berman, Zoe P; Boczar, Daniel; Trilles, Jorge; Siringo, Nicolette V.; Diep, Gustave K; Colon, Ricardo Rodriguez; Rodriguez, Eduardo D.

doi:10.1089/lgbt.2021.0224

Cited by 35 publications

(23 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Children and young adults with gender dysphoria deserve a good research basis for their treatment and a critical consideration of the risks and benefits of procedures like chest masculinisation mastectomy (73). The number of people currently undergoing chest masculinisation mastectomy is increasing (74). Given that many women have their first baby in their 30s, there may be a decade or two between surgery and pregnancy during which regret may surface.…”

Section: Discussionmentioning

confidence: 99%

Breastfeeding grief after chest masculinisation mastectomy and detransition: A case report with lessons about unanticipated harm

Gribble

Bewley

Dahlen

2023

Front. Glob. Womens Health

View full text Add to dashboard Cite

An increasing number of young females are undergoing chest masculinsation mastectomy to affirm a gender identity and/or to relieve gender dysphoria. Some desist in their transgender identification and/or become reconciled with their sex, and then revert (or detransition). To the best of our knowledge, this report presents the first published case of a woman who had chest masculinisation surgery to affirm a gender identity as a trans man, but who later detransitioned, became pregnant and grieved her inability to breastfeed. She described a lack of understanding by maternity health providers of her experience and the importance she placed on breastfeeding. Subsequent poor maternity care contributed to her distress. The absence of breast function as a consideration in transgender surgical literature is highlighted. That breastfeeding is missing in counselling and consent guidelines for chest masculinisation mastectomy is also described as is the poor quality of existing research on detransition rates and benefit or otherwise of chest masculinising mastectomy. Recommendations are made for improving maternity care for detransitioned women1. Increasing numbers of chest masculinsation mastectomies will likely be followed by more new mothers without functioning breasts who will require honest, knowledgeable, and compassionate support.

show abstract

Section: Discussionmentioning

confidence: 99%

Breastfeeding grief after chest masculinisation mastectomy and detransition: A case report with lessons about unanticipated harm

Gribble

Bewley

Dahlen

2023

Front. Glob. Womens Health

View full text Add to dashboard Cite

show abstract

“…Procedures that were reimbursed less than 1 wRVU or had operative time of zero were also excluded as these do not represent a typical plastic and/or GAS procedure. Gender-affirming surgery procedures were identified by postoperative diagnosis relating to “gender identity disorders” (International Classification of Disease codes Z87.890, F64, F64.0, F64.1, F64.2, F64.8, F64.9, F66.0), as previously described 8 . Cases without this designation were placed in the general plastics (non-GAS) cohort if they were performed over 200 times in the 4 year study period, as this is more representative of a typical plastic surgery procedure.…”

Section: Methodsmentioning

confidence: 99%

“…Gender-affirming surgery procedures were identified by postoperative diagnosis relating to "gender identity disorders" (International Classification of Disease codes Z87.890, F64, F64.0, F64.1, F64.2, F64.8, F64.9, F66.0), as previously described. 8 Cases without this designation were placed in the general plastics (non-GAS) cohort if they were performed over 200 times in the 4 year study period, as this is more representative of a typical plastic surgery procedure. The cohorts were then assessed for duplicate Current Procedural Terminology (CPT) cases and these cases were removed.…”

Section: Databasementioning

confidence: 99%

Are Gender-Affirming Plastic Surgeons Adequately Compensated? An Analysis of Relative Value Units

Oleru,

Seyidova,

Taub

2024

Ann Plast Surg

View full text Add to dashboard Cite

Background Gender-affirming surgery (GAS) has a complicated history within US health care. As GAS procedures and reimbursement availability continue to uptrend, the present study aims to investigate whether compensation is equitable between GAS procedures and general plastic surgery procedures. Methods The National Surgical Quality Improvement Program database was queried for all surgeries performed by plastic surgeons from 2016 to 2020. Cases were assigned to the GAS or non-GAS cohort using ICD-10 codes. Duplicate Current Procedural Terminology (CPT) codes were removed for analysis. Operative time, total wRVUs, wRVUs per hour (wRVU/h), reoperation/readmission rate, and number of concurrent procedures were compared between the cohorts. Results A total of 132,319 non-GAS and 3,583 GAS were identified. After duplicate CPT removal, 299 cases (21 unique CPTs) remained in the GAS cohort and 20,022 (37 unique CPTs) in the non-GAS cohort. Operative time was higher in the GAS cohort (262.9 vs 120.7 min, P < 0.001), as were total wRVUs (59.4 vs 21.6, P < 0.001). Reoperation/readmission rate (7.0% vs 6.0%) and wRVU/h (15.8 vs 15.1) were not significantly different (all P > 0.05). There was a positive correlation between total operative time and total wRVUs (P < 0.001) and a negative correlation between total operative time and wRVU/h (P < 0.001). Conclusions Proportional wRVUs are allocated to gender affirming plastic procedures. However, the RVU scale does not allocate proportional wRVUs to longer operative times for both GAS and general plastic surgeries. Compensation for gender affirming plastic surgeries is higher than that of general plastic surgeries; however, there is no difference in wRVUs per hour on comparison.

show abstract

“…1 The population of transgender and gender diverse (TGD) Americans has been estimated to near 2 million, corresponding to a prevalence of 9.2 per 100,000 individuals. 2,3 These numbers may underrepresent the true number of Americans experiencing gender dysphoria, as underreporting is driven by the stigma associated with transgender populations. 4 A recent study indicated that the incidence of patients receiving gender-affirming surgery (GAS) has increased 152-fold from 2010 to 2018.…”

Section: Introductionmentioning

confidence: 99%

“…4 A recent study indicated that the incidence of patients receiving gender-affirming surgery (GAS) has increased 152-fold from 2010 to 2018. 2 GAS represents one type of gender-affirming care, which many transgender individuals choose to pursue. A recent study estimated that 42%-54% of transgender men, 28% of transgender women, and 9% of nonbinary people pursue GAS of any type, with the most common being chest/breast surgery (8-25%) and the second being genital surgery (4%-13%).…”

Section: Introductionmentioning

confidence: 99%

Quality Assessment of Online Resources for Gender-affirming Surgery

Berry,

Fazilat,

Churukian

et al. 2023

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background: As visibility of the transgender patient population and utilization of online resources increases, it is imperative that web-based gender-affirming surgery (GAS) materials for patients are readable, accessible, and of high quality. Methods: A search trends analysis was performed to determine frequency of GAS-related searches over time. The top 100 most common results for GAS-related terms were analyzed using six readability formulas. Accessibility of patient-facing GAS sources was determined by categorizing types of search results. Frequency of article types was compared in low- and high-population dense areas. Quality was assigned to GAS web-based sources using the DISCERN score. Results: Search engine trend data demonstrates increasing occurrence of searches related to GAS. Readability scores of the top 100 online sources for GAS were discovered to exceed recommended levels for patient proficiency. Availability of patient-facing online information related to GAS was found to be 60%, followed by information provided by insurance companies (17%). Differences in availability of online resources in varying dense cities were found to be minimal. The average quality of sources determined by the DISCERN score was found to be 3, indicating “potential important shortcomings.” Conclusions: Despite increasing demand for web-based GAS information, the readability of online resources related to GAS was found to be significantly greater than the grade level of proficiency recommended for patients. A high number of nonpatient-facing search results appear in response to GAS search terms. Quality sources are still difficult for patients to find, as search results have a high incidence of low-quality resources.

show abstract

Gender Affirmation Surgery on the Rise: Analysis of Trends and Outcomes

Cited by 35 publications

References 26 publications

Breastfeeding grief after chest masculinisation mastectomy and detransition: A case report with lessons about unanticipated harm

Breastfeeding grief after chest masculinisation mastectomy and detransition: A case report with lessons about unanticipated harm

Are Gender-Affirming Plastic Surgeons Adequately Compensated? An Analysis of Relative Value Units

Quality Assessment of Online Resources for Gender-affirming Surgery

Contact Info

Product

Resources

About