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The relationship between mental health professionals and surgeons has evolved. It shifted from gatekeeping to shared decision-making in gender-affirming care.

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Area of Science:

  • Medical Ethics
  • Gender Studies
  • Surgical Care

Background:

  • Gender incongruence is a condition where gender identity differs from sex assigned at birth.
  • Gender-affirmation surgery is a crucial intervention for individuals experiencing gender incongruence.
  • Clinical decisions are guided by the Standards of Care, international guidelines.

Purpose of the Study:

  • To discuss the historical and evolving relationship between mental health care professionals (MHCPs) and surgeons in gender-affirming care.
  • To provide insight into the changing roles of MHCPs in the surgical candidacy process.

Main Methods:

  • Historical analysis of the collaboration between MHCPs and surgeons.
  • Review of the evolution of clinical guidelines and their impact on practice.
  • Examination of the shift in the MHCP's role from gatekeeper to collaborator.

Main Results:

  • Historically, MHCPs and surgeons collaborated to select surgical candidates.
  • The role of MHCPs has transitioned from verifying identity to supporting shared decision-making.
  • Evolving understanding of gender identity has reshaped the MHCP-surgeon dynamic.

Conclusions:

  • The collaborative relationship between MHCPs and surgeons in gender-affirming care has significantly evolved.
  • The modern approach emphasizes shared decision-making, with MHCPs acting as supportive partners.
  • Understanding this evolution is key to providing patient-centered gender-affirming surgical care.