Comparing Gender Congruency in Nonsurgical versus Postsurgical Top Surgery Patients: A Prospective Survey Study

Area of Science:

• Medical research
• Gender studies
• Surgical outcomes

Background:

• Gender dysphoria negatively impacts quality of life.
• Hormone replacement therapy (HRT) and gender-affirming surgery are key treatments.
• Access to care remains a significant barrier for many transgender individuals.

Purpose of the Study:

• Compare outcomes of top surgery plus HRT versus HRT alone.
• Assess gender congruency, patient satisfaction, and discrimination levels.
• Identify barriers to accessing gender-affirming surgical care.

Main Methods:

• Recruited transgender and nonbinary individuals with at least 6 months of HRT.
• Administered surveys on gender congruency, discrimination, and care barriers.
• Utilized the BREAST-Q for postoperative satisfaction assessment in surgical patients.
• Employed Mann-Whitney U test for statistical comparison between groups.

Main Results:

• Top surgery patients reported significantly higher gender congruency (P < 0.001).
• Surgical group experienced less discrimination, violence, and verbal abuse (P < 0.003).
• 87.1% in the HRT-only group desired surgery, with 62.5% facing barriers (cost, insurance).
• High postoperative satisfaction reported by surgical patients across BREAST-Q categories.

Conclusions:

• Top surgery, alongside HRT, substantially enhances gender congruency and reduces discrimination.
• HRT alone is less effective in improving physical body representation of gender identity.
• Cost and insurance coverage are primary obstacles preventing access to necessary surgical interventions.