Long-Term Regret and Satisfaction With Decision Following Gender-Affirming Mastectomy

Area of Science:

• Medical research
• Surgical outcomes
• Patient-reported outcomes

Background:

• Legislative interest in gender-affirming surgery is rising, partly due to concerns about decisional regret.
• Previous estimates of regret after gender-affirming surgery (GAS) relied on non-validated instruments.
• Understanding long-term patient satisfaction and regret is crucial for informed decision-making and policy.

Purpose of the Study:

• To evaluate long-term decisional regret and satisfaction with the decision following gender-affirming mastectomy.
• To utilize validated instruments for assessing patient-reported outcomes after gender-affirming mastectomy.

Main Methods:

• A cross-sectional survey was administered to patients who underwent gender-affirming mastectomy between 1990 and 2020.
• Validated instruments, including the Satisfaction With Decision Scale and Decision Regret Scale, were used.
• Patient-reported outcomes and medical records were analyzed using descriptive statistics and univariable analysis.

Main Results:

• The study included 139 responders with a median follow-up of 3.6 years.
• Responders reported a median Satisfaction With Decision score of 5.0 and a median Decision Regret score of 0.0.
• No patients requested or underwent reversal procedures, and statistical analysis for predictors of regret was limited by a lack of variation in responses.

Conclusions:

• Validated instruments show low decisional regret and high satisfaction following gender-affirming mastectomy.
• The findings underscore the positive long-term outcomes and patient contentment with gender-affirming mastectomy.
• Further research may require condition-specific instruments to better assess nuanced outcomes in GAS.