Gender-affirming surgery refers to any surgical procedures offered to affirm the gender identities of transgender and gender diverse (TGD) people. Evidence supporting a positive effect of gender-affirming surgeries on mental health is largely derived from low-quality studies. A secondary analysis of the 2015 US Transgender Survey evaluating the associations between gender-affirming surgery and self-reported mental health outcomes among TGD adults was recently published. Of 27,715 respondents, 3,559 (12.8%) endorsed undergoing 1 or more types of gender-affirming surgeries at least 2 years prior to completing the survey (exposure group), while 16,401 (59.2%) endorsed a desire to undergo 1 or more types of surgery but denied undergoing any of these (control group). After adjusting for sociodemographic factors and exposure to other gender affirming care (e.g., hormone therapy), undergoing 1 or more types of gender-affirming surgery was associated with lower past-month psychological distress (aOR, 0.58; 95% CI, 0.50-0.67; p<0.001), past-year smoking (aOR, 0.65; 95% CI, 0.57-0.75; p<0.001), and past-year suicidal ideation (aOR, 0.56; 95% CI, 0.50-0.64; p<0.001), compared to control. After Bonferroni correction, undergoing 1 or more gender-affirming surgery was not significantly associated with past-month binge alcohol use or past-year suicide attempt, compared to control. This first large-scale, controlled study demonstrates an association between gender-affirming surgery and improved mental health outcomes in TGD adults that is consistent with previous small-sample studies. These findings offer evidence to support the clinical practice of gender affirming surgery and highlight the importance of policies that facilitate access to surgical gender affirmation.
References:
Almazan AN, Keuroghlian AS. JAMA Surg 2021; epub ahead of print. Abstract
Marano AA et al. JAMA Surg 2021; epub ahead of print. Abstract
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