Transgender surgery – Knowledge gap among physicians impacting patient care

Abstract

Transgender surgeries are increasingly performed across the globe and in the United States. Although comprehensive centers exist, which are well equipped to cater and tailor to the needs of this population subset, quite often their resultant complications are handled at a different institution owing to the acuity of the condition. However, interestingly the psychosocial needs, medical pathophysiology, available surgical procedures, and their resultant complications are still not a part of the regular medical curriculum. This translates into inadequate care when physicians from vast majority of institutions that do not routinely perform transgender surgery encounter these patients with complications from gender-affirming surgeries. We present a case of a patient who underwent complex multiple gender-affirming surgeries, presenting to our emergency department with an acute abdomen; this resulted in a diagnostic and management dilemma and review of brief pertinent literature. We recommend that transgender medicine and its basics needs should be exposed to currently practicing physicians by continuing medical education, trainees and medical students alike via incorporation into their curriculum, to decrease health disparities among the lesbian, gay, bisexual, transgender, and queer community.

Emergency care considerations for transgender and gender diverse youth: a review to improve health trajectories

“…Currently, very few transgender surgeries are performed on youth in the United States. Literature focused on adult patients does note a variable rate of complication, dependent on the procedure performed [21]. As with all pediatric patients, TGD youth should be well informed about details of the surgery and possible complications, undergo behavioral health evaluation, and consult all members of their care team, prior to making the decision to undergo a life changing and possibly irreversible procedure [11 && ].…”

Urinary symptoms after genital gender-affirming penile construction, urethral lengthening and vaginectomy

“…Retrospective review of a cohort of 55 GGAS patients with urinary complications revealed that within a median of four months of surgery, nearly 75% of patients presented with two or more complications: 86% strictures and 56% fistulae (46). Many patients travel long distances for their initial GGAS (47), therefore this is relevant for urologists across the country (48).…”

Bilateral Urinary Stones in a Transgender Woman: A Case Report in Lebanon

“…Transgender individuals, those whose gender identity differs from the sex assigned at birth, often pursue gender-affirming medical interventions, including hormone therapy and various surgical procedures [ 1 ]. These interventions can lead to complex anatomical considerations, such as the presence of neovagina and, as highlighted in this case, the presence of a prostate.…”