Gender-Affirming Surgery Price Transparency and Online Information Availability in US Hospitals

Many transgender and gender-diverse (TGD) individuals rely on online resources to obtain gender-affirming surgery (GAS) information. In 2021, US Centers for Medicare and Medicaid Services (CMS) mandated that hospitals disclose prices for common services and procedures. The aim of this study was to assess the online information and price availability for GAS in US-based hospitals.

The largest 100 hospitals by inpatient bed volume were included. Hospital websites were searched in October 2023 for terms pertaining to GAS, and price estimator tools were queried for 66 common CPT codes used in GAS. Data on hospital ownership, hospital income, Medicaid revenue, plastic surgery residency program presence, ZIP code median income, social vulnerability index score, and state-level nondiscrimination laws were also collected.

Out of 100 hospitals, 59 publicly offered GAS. Hospitals located in the US South and Church-owned hospitals were the least likely to have any GAS information availability (41.5% and 36.4%, respectively). Hospitals in states with laws protecting GAS insurance access and those with plastic surgery residency programs were more likely to publicly offer GAS. Only 48 hospitals offered any GAS pricing information. Of these hospitals, the median number of prices displayed was two, and only five hospitals disclosed prices for more than ten procedures. Pricing information was particularly limited for genital and facial procedures.

Significant gaps exist in the public availability of GAS information and price transparency, with notable regional and institutional disparities. Standardizing price estimator tools would enhance informed decision-making and reduce barriers to care. http://www.springer.com/00266 LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .