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Psychosurgery01:30

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Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
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Nonbinary and transgender (trans-) male patients seeking chest masculinization surgery have different preferences, particularly regarding nipple-areola preservation. Understanding these distinct desires is crucial for surgical planning.

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Area of Science:

  • Gender-affirming surgery
  • Plastic surgery
  • Patient-centered care

Background:

  • Chest masculinization surgery is a key component of gender affirmation for transgender (trans-) males.
  • Nonbinary individuals also seek chest masculinization, but their preferences may differ.
  • Understanding these differences is vital for optimizing surgical outcomes and patient satisfaction.

Purpose of the Study:

  • To compare patient preferences and surgical outcomes of chest masculinization between nonbinary and trans-male individuals.
  • To identify unique surgical requests and aesthetic goals within each group.

Main Methods:

  • Retrospective review of patients undergoing chest masculinization between 2003 and 2022.
  • Comparison of demographics, surgical techniques, complications, and BODY-Q chest module survey responses.
  • Analysis of specific patient requests, including nipple-areola complex modifications.

Main Results:

  • Nonbinary patients (13%) had distinct preferences, including higher rates of nipple-areola preservation avoidance and unique requests for androgyny.
  • While both groups reported improved quality of life, trans-male patients more strongly associated a male chest with gender identity.
  • Nonbinary patients were less likely to prefer small nipples and more likely to prefer no nipples.

Conclusions:

  • Nonbinary patients exhibit unique surgical preferences for chest masculinization, especially concerning nipple-areola complexes.
  • Surgical planning for chest masculinization should be individualized to accommodate the distinct needs and preferences of nonbinary patients compared to trans-male patients.