Clinical Outcomes of Gender-Affirming Surgery in Individuals With Connective Tissue Disorders

Area of Science:

• Medical research
• Surgical outcomes
• Patient safety

Background:

• Gender-affirming surgery (GAS) is a complex, multi-stage process.
• Connective tissue disorders (CTDs) may increase surgical complication risks.
• Investigating CTD impact on GAS outcomes is crucial for patient care.

Purpose of the Study:

• To determine the association between connective tissue disorder diagnoses and outcomes following gender-affirming surgery.
• To identify risk factors for postoperative complications and readmissions in GAS patients.

Main Methods:

• Retrospective analysis of 7575 patients undergoing GAS (2007-2022) using Merative MarketScan Research Databases.
• Comparison of postoperative complications and readmissions between patients with and without CTD diagnoses.
• Statistical analysis including chi-squared, Shapiro-Wilk, Wilcoxon-Mann-Whitney, and multivariate logistic regression.

Main Results:

• No statistically significant difference in overall postoperative complications between CTD and non-CTD patients.
• CTD diagnoses (P=0.52) did not increase odds of index procedure complications.
• CTD diagnoses increased readmission odds (OR 1.47; P=0.046), alongside other factors like smoking and multiple simultaneous procedures.

Conclusions:

• Connective tissue disorders may influence specific gender-affirming surgical outcomes, particularly readmission rates.
• Preoperative evaluation and comorbidity management are essential for mitigating risks in this patient population.
• Surgeons should exercise caution with elective surgeries in patients on immunomodulatory medications.