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

被引:37
作者
Chaya, Bachar F. [1 ]
Berman, Zoe P. [1 ]
Boczar, Daniel [1 ]
Trilles, Jorge [1 ]
Siringo, Nicolette, V [1 ]
Diep, Gustave K. [1 ]
Colon, Ricardo Rodriguez [1 ]
Rodriguez, Eduardo D. [1 ]
机构
[1] NYU Langone Hlth, Hansjorg Wyss Dept Plast Surg, 222 East 41st St,6th Floor, New York, NY 10017 USA
关键词
gender-affirming surgery; gender dysphoria; reconstructive surgery; transgender; AFFIRMING SURGERY; COMPLICATIONS; VAGINOPLASTY; ADOLESCENTS; COVERAGE; CARE;
D O I
10.1089/lgbt.2021.0224
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Purpose: Gender-affirming surgery (GAS) has become an important component of the treatment of gender dysphoria. Although the frequency of these procedures is on the rise, a complete safety profile has yet to be established. The goal of our study is to analyze the trends and outcomes of these surgical procedures.Methods: All patients with a primary diagnosis of gender dysphoria undergoing GAS were identified from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database between the years 2009 and 2018. Patient demographics and 30-day postoperative outcomes were recorded. We performed a multivariate logistic regression for postoperative complications, controlling for several confounding variables.Results: We identified 2956 patients, of which 1767 (59.78%) were transgender men and 1189 (40.22%) were transgender women. The number of patients undergoing GAS per year increased from 7 in 2010 to 1069 in 2018, a 152-fold increase. For patients undergoing top surgery, Black race (odds ratio [OR] = 2.255, 95% confidence interval [CI] 1.189-4.277, p = 0.013) and diabetes (OR = 4.156, 95% CI 1.571-10.999, p = 0.004) were independent predictors of 30-day postoperative complications. For patients undergoing bottom surgery, total operative time in minutes (OR = 1.005, 95% CI 1.003-1.007, p = 0.001) was an independent predictor of 30-day postoperative complications.Conclusion: The demand for GAS has increased exponentially since 2014. While postoperative complication rates are acceptable, Black race was shown to be an independent predictor of postoperative morbidity in patients undergoing top surgery, a finding that calls for further investigation of racial disparities among transgender patients.
引用
收藏
页码:582 / 588
页数:7
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