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Gender Affirming Surgery in Nonbinary Patients: A Single Institutional Experience.

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Gender-affirming care for nonbinary individuals is increasing. This study found nonbinary patients assigned male at birth (NB-AMAB) predominantly receive hormone therapy, while those assigned female at birth (NB-AFAB) pursue surgery.

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facial feminization surgerygender dysphoriagender-affirming surgerynonbinaryreconstructive craniofacial surgery

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Area of Science:

  • Medical Science
  • Gender Studies
  • Surgical Procedures

Background:

  • Growing number of nonbinary individuals seeking gender-affirming procedures.
  • Limited understanding of preferred treatments for nonbinary patients.
  • Improved access to gender-affirming care facilitates these procedures.

Purpose of the Study:

  • To investigate the specific treatment goals of nonbinary patients.
  • To analyze the types of gender-affirming procedures sought by nonbinary individuals.
  • To understand the demographic and clinical characteristics influencing treatment decisions.

Main Methods:

  • Retrospective study of nonbinary patients within an institutional Gender Health Program.
  • Analysis of patient demographics, clinical characteristics, and surgical goals.
  • Review of operative variables and treatment outcomes.

Main Results:

  • Out of 375 gender dysphoria patients, 67 (18%) identified as nonbinary.
  • Most nonbinary patients were assigned male at birth (85%); 49% preferred they/them pronouns.
  • 66% received hormone therapy, and 69% desired or underwent gender-affirming surgery (e.g., facial feminization, vaginoplasty, mastectomy, orchiectomy).
  • Nonbinary patients assigned male at birth (NB-AMAB) were more likely to receive hormone therapy (72% vs. 30%), while nonbinary patients assigned female at birth (NB-AFAB) were more likely to undergo surgery (100% vs. 63%).

Conclusions:

  • The majority of nonbinary patients in this cohort were assigned male at birth.
  • NB-AFAB patients exclusively pursued surgical interventions.
  • NB-AMAB patients were primarily treated with hormone therapy, indicating different treatment pathways based on assigned sex at birth.