Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence

Bustos, Valeria P.; Bustos, Samyd S.; Mascaró, Andrés; Corral, Gabriel Del; Forte, Antonio J.; Ciudad, Pedro; Kim, Esther A.; Langstein, Howard N.; Manrique, Oscar J.

doi:10.1097/gox.0000000000003477

Cited by 91 publications

(74 citation statements)

References 45 publications

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“…In terms of detransition rates, one meta-analysis reports rates of less than one percent [ 50 ] but the primary studies are inherently flawed by loss to follow up. A recent UK GIC case note review found a detransition rate of 6.9% [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

Care of Transgender Patients: A General Practice Quality Improvement Approach

Boyd¹,

Hackett

Bewley

2022

Healthcare

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Primary care must ensure high quality lifelong care is offered to trans and gender minority patients who are known to have poor health and adverse healthcare experiences. This quality improvement project aimed to interrogate and audit the data of trans and gender minority patients in one primary care population in England. A new data collection instrument was created examining pathways of care, assessments and interventions undertaken, monitoring, and complications. General practitioners identified a sample from the patient population and then performed an audit to examine against an established standard of care. No appropriate primary care audit standard was found. There was inconsistency between multiple UK gender identity clinics’ (GIC) individual recommended schedules of care and between specialty guidelines. Using an international, secondary care, evidence-informed guideline, it appeared that up to two-thirds of patients did not receive all recommended monitoring standards, largely due to inconsistencies between GIC and international guidance. It is imperative that an evidence-based primary care guideline is devised alongside measurable standards. Given the findings of long waits, high rates of medical complexity, and some undesired treatment outcomes (including a fifth of patients stopping hormones of whom more than half cited regret or detransition experiences), this small but population-based quality improvement approach should be replicated and expanded upon at scale.

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Section: Discussionmentioning

confidence: 99%

Care of Transgender Patients: A General Practice Quality Improvement Approach

Boyd¹,

Hackett

Bewley

2022

Healthcare

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“…Penile inversion vaginoplasty is the gold standard surgical technique of feminizing genital surgery (Bizic et al, 2014;Horbach et al, 2015;Buncamper et al, 2016;Dreher et al, 2018;Bustos et al, 2021;Moises da Silva et al, 2021). This surgery was first introduced in the early 1900's and has undergone various permutations in search of the optimal outcome (Horbach et al, 2015).…”

Section: Vaginoplasty and The Neovaginal Epitheliummentioning

confidence: 99%

The Effect of Gender-Affirming Medical Care on the Vaginal and Neovaginal Microbiomes of Transgender and Gender-Diverse People

Krakowsky

Potter

Hallarn

et al. 2022

Front. Cell. Infect. Microbiol.

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Transgender and gender diverse individuals may seek gender-affirming medical care, such as hormone therapy or surgery, to produce primary and/or secondary sex characteristics that are more congruent with their gender. Gender-affirming medical care for transmasculine individuals can include testosterone therapy, which suppresses circulating estrogen and can lead to changes in the vaginal epithelium that are reminiscent of the post-menopausal period in cisgender females. Among transfeminine individuals, gender-affirming medical care can include vaginoplasty, which is the surgical creation of a vulva and neovaginal canal, commonly using penile and scrotal skin. The effect of gender-affirming medical care on the vagina of transmasculine individuals and on the neovagina of transfeminine individuals is poorly characterized. This review summarizes what is known of the epithelium and local microbiota of the testosterone-exposed vagina and the neovagina. We focus on potential pathogens and determinants of gynecological health and identify key knowledge gaps for future research.

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“…Bustos et al 1 aimed to measure the prevalence of regret following gender-affirmation surgery. Given the significant rise in young people seeking medical intervention for gender dysphoria, which can include surgery, outcome studies that accurately assess regret are of increasing importance.…”

Section: Sirmentioning

confidence: 99%

“…Bustos et al 1 acknowledge “moderate-to-high risk of bias in some studies.” Actually, this affects 23 of the 27 studies. The majority of included studies ranged between “poor” and “fair” quality: only five studies—representing just 3% (174) of total participants—received higher quality ratings.…”

Section: Sirmentioning

confidence: 99%