National Trends in Gender-Affirming Surgical Procedures: A Google Trends Analysis

Abstract

Background: There has been a significant increase in the volume of gender-affirming surgical (GAS) procedures over the past decade. The objective of this paper is to use online search data from Google Trends (GT) to describe national search trends for GAS procedures.Methods: GT was queried for search terms relating to GAS from January 2004 to February 2021. The 19 selected keywords covered a broad range of GAS topics. United States (US) search interest was collected as relative search volumes (RSVs) and then analyzed by geographic region. The number of plastic surgery providers offering GAS and academic surgery centers was collected from the World Professional Association for Transgender Health (WPATH) and Trans-health.com. RSVs were analyzed by metro area to determine the relationship between search demand and personal income. State Medicaid policies for transgender health services were also collected.Results: All search terms demonstrated a positive increase in RSVs over time except "sex reassignment surgery" and "penectomy". The Mountain/Pacific and East South Central/West South Central had the greatest search volume for GAS and most providers offering care. The East South Central/West South Central region ranked last for providers offering care, despite the relatively high search interest. This region also had no states with explicit Medicaid policies covering gender-affirming care. Metro areas in the top five for RSV but bottom quartile for per capita personal income were identified.Conclusions: Online search interest for GAS-related terms has increased. Search interest for GAS has regional variation and did not show a specific pattern with provider availability.

National Estimates of Gender-Affirming Surgery in the US

“…A prior study examining national estimates of inpatient GAS procedures noted that the absolute number of procedures performed nearly doubled between 2000 to 2005 and from 2006 to 2011. In our analysis, the number of GAS procedures nearly tripled from 2016 to 2020 . Not unexpectedly, a large number of the procedures we captured were performed in the ambulatory setting, highlighting the need to capture both inpatient and outpatient procedures when analyzing data on trends.…”

Developing Gender-Affirming Surgery Curricula for Plastic Surgery Residency and Fellowship via Delphi Consensus

“…This geographic distribution is reflective of the national distribution of gender-affirming surgeons in the country, where most gender-affirming surgeons (33%) are located on the West Coast and fewer are in the South (9%). 21…”

“…This geographic distribution is reflective of the national distribution of gender-affirming surgeons in the country, where most gender-affirming surgeons (33%) are located on the West Coast and fewer are in the South (9%). 21 Of the 39 invited panelists, 34 (87%) responded to the first survey round and were included in the final analyses. Thirty-two panelists (82%) completed all three surveys.…”

Evaluation and management of urologic complications following transmasculine genital reconstructive surgery

“…1 Transmasculine genital reconstructive surgery (GRS) is offered at increasingly growing numbers nationally across 46 academic medical centers. 2 Transmasculine GRS comprises of both extirpative and reconstructive components. Extirpative procedures consist of the removal of female reproductive organs, while GRS is personalized to each patient's unique anatomy and goals.…”

“…Over 1.6 million adolescents and adults identify as transgender in the United States, 35.9% of which are transgender men 1 . Transmasculine genital reconstructive surgery (GRS) is offered at increasingly growing numbers nationally across 46 academic medical centers 2 . Transmasculine GRS comprises of both extirpative and reconstructive components.…”