Temporal Trends in Gender-Affirming Surgery Among Transgender Patients in the United States

Canner, Joseph K.; Harfouch, Omar; Kodadek, Lisa M.; Pelaez, Danielle; Coon, Devin; Offodile, Anaeze C.; Haider, Adil H.; Lau, Brandyn

doi:10.1001/jamasurg.2017.6231

Cited by 315 publications

(236 citation statements)

References 33 publications

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“…From 2010 to 2016, the number of Medicare beneficiaries identified as transgender based on diagnosis codes increased each year, and the cumulative number of transgender beneficiaries grew more than eightfold from 2010 to 2016. These data are consistent with findings from other studies, 35 including those conducted with patients in the U.S. Veterans Health Administration (VHA), which have found similar rates of growth in the number of transgender patients seen by VHA providers. 25 Furthermore, there was a near-doubling in transgender beneficiaries identified after the transition to ICD-10; however, there was evidence that the population was already growing before the change in the coding system.…”

Section: Discussionsupporting

confidence: 90%

“…transgender patients nearly tripled from 2012-2013 to 2014. 35 In addition, a federal ban on discrimination against patients based on gender identity was enacted in May 2016, in addition to many current and new state and local bans. 38,39 However, it is important to note that an injunction was put in place against the federal ban in December 2016.…”

Section: Discussionmentioning

confidence: 99%

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Identifying Medicare Beneficiaries Accessing Transgender-Related Care in the Era of ICD-10

et al. 2019

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Purpose: The study purpose was to describe trends in the size and demographics of the population of transgender Medicare beneficiaries identified using International Classification of Diseases (ICD) Clinical Modification codes over time. We also assessed how the change from ICD, Ninth Revision (ICD-9) diagnosis codes to ICD, 10th Revision (ICD-10) diagnosis codes in October 2015 has affected the ability to identify transgender beneficiaries within claims data. Methods: We used Medicare Fee-for-Service claims within the Centers for Medicare & Medicaid Services Chronic Conditions Data Warehouse from 2010 through 2016 to identify transgender beneficiaries. We linked these data to Medicare enrollment records to study demographic trends. Results: Within the Medicare program, the number of beneficiaries identified as transgender through claims data in each year has increased from 2088 beneficiaries in 2010 to 10,242 beneficiaries in 2016 (a 390% increase). The highest numbers of transgender beneficiaries were identified in 2015 and 2016, which coincide with the change to ICD-10. Similarly, more beneficiaries were identified as transgender in the 12 months after the change to ICD-10 (N = 8733) than in the 12 months before (N = 4857). Conclusion: Given that a first and critical step to better understand and eliminate health disparities and deliver culturally competent care is to identify and characterize the population of interest, this study provides an innovative view into how the change to the ICD-10 coding system affects the ability to study a transgender cohort within Medicare claims data.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Identifying Medicare Beneficiaries Accessing Transgender-Related Care in the Era of ICD-10

et al. 2019

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“…Again, not having access to gender affirming care results in higher costs and poor health outcomes for transgender individuals (Padula & Baker, 2017). Unfortunately, many reconstructive surgeries are not covered by health insurance (Canner et al, 2018), and therefore, cost poses a large barrier to care for many transgender individuals (Padula & Baker, 2017;Sineath et al, 2016). However, prophylactic surgeries like bilateral mastectomies and oophorectomies are likely to be covered for patients who have a pathogenic variant in genes associated with a high cancer risk (Kauff et al, 2001).…”

Section: Unique Clinical Indications and Scenarios With Transgendermentioning

confidence: 99%

Cancer genetic counselors' experiences with transgender patients: A qualitative study

Zayhowski

Park

Boehmer

et al. 2019

Journal of Genetic Counseling

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It is becoming increasingly common for people to openly identify as transgender, yet there is little research in the field of genetic counseling regarding this community's unique medical needs. Transgender patients are likely to present with issues that cross genetics and gender‐related care in a cancer genetic counseling session, and empiric data about these differences is needed to provide adequate care. In order to investigate what specific health topics and concerns are addressed in cancer genetic counseling sessions with transgender patients, 21 cancer genetic counselors who have seen transgender patients were interviewed. Through inductive analysis, six themes emerged: (1) documentation systems are not inclusive or clear; (2) genetic counselors feel unprepared for these sessions; (3) gender affirming hormones impact risk assessment; (4) genetic testing affects gender affirming surgical decisions; (5) transgender patients present at younger ages to clinic; and (6) pathogenic variants allow for insurance coverage for gender affirming surgeries. This study's findings point to opportunities for the field of genetic counseling to enhance services for transgender patients by reporting distinctive situations that may arise in clinic with these patients and providing training recommendations for genetic counselors.

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“…Certainly, as society becomes more aware and accepting of gender variance, it is likely that more individuals will feel comfortable coming out as transgender and may do so at a younger age. It can therefore be expected that more transgender youth may be encountered in the perioperative setting, a trend already seen in the adult population 7 . Pediatric anesthesiologists should be aware of the unique characteristics and vulnerabilities of this population in order to provide the best and most affirming care.…”

Section: Introductionmentioning

confidence: 99%

Transgender pediatric surgical patients—Important perioperative considerations

Roque

2020

Pediatric Anesthesia

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Transgender describes a variety of identities in which an individual's gender identity is different from expected based on the sex assigned at birth. In the United States, it is estimated that over 1 million adults and 150 000 youth identify as transgender, with increasing numbers being seen in healthcare and surgical settings. These numbers will continue to rise as visibility and acceptance grow. Current guidelines recommend transition‐related surgeries be reserved for older adolescents and adults. However, this is not the only circumstance in which the pediatric anesthesiologist may find themselves caring for a transgender patient. In order to provide the safest and most affirming care, it is crucial that the pediatric anesthesiologist develop a working knowledge of this unique and vulnerable population, including the potential impacts of gender‐affirming treatment on their perioperative care.

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Temporal Trends in Gender-Affirming Surgery Among Transgender Patients in the United States

Cited by 315 publications

References 33 publications

Identifying Medicare Beneficiaries Accessing Transgender-Related Care in the Era of ICD-10

Identifying Medicare Beneficiaries Accessing Transgender-Related Care in the Era of ICD-10

Cancer genetic counselors' experiences with transgender patients: A qualitative study

Transgender pediatric surgical patients—Important perioperative considerations

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