Embodied Affirmation: Experiences with Gender-Affirming Top Surgery

Gender-affirming top surgery is an increasingly requested procedure by individuals to address gender dysphoria. On Instagram and TikTok, "#TopSurgery" is currently the most common gender-affirming surgery hashtag, with most content being shared by patients. This study aims to analyze online posts to elucidate patient perceptions and information dissemination related to gender-affirming top surgery.

Instagram and TikTok were queried under "#TopSurgery." Public patient posts discussing their gender-affirming top surgery experiences were collected. Across 808 posts made after 2020, forty-two subthemes were identified reflecting gender-Q foci and were grouped into five central motifs.

The five central motifs were Psychosocial and Emotional Well-being (31%), Empowerment and Identity Formation (30%), Navigating the Medical Journey (17%), Physical Health and Body Image (16%), and Allies and Stigma (6%). The most common subthemes were Appearance & Body Image (587, 73%), Satisfaction and Relief (576, 71%), Empowerment & Confidence (554, 69%), Positivity & Inspiration (535, 66%), Quality of Life & Mental Health (496, 61%), Self-Esteem & Identity Affirmation (470, 58%), Milestones & Achievements (404, 50%), and Outreach & Health Literacy (306, 38%).

Significant differences existed between social media posts shared on Instagram and TikTok, those made before and after surgery, and by those of different identities. Patients use social media to share experiences with gender-affirming top surgery, including emotional, physical, and lifestyle changes. Themes of these posts vary by platform, surgical stage, and gender identity. These insights can enhance the physician-patient relationship, improving counseling, setting patient expectations, and navigating the pre/postoperative period.

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