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Upper Extremity Surgical Outcomes in Transgender Trauma Patients.

Samantha Maasarani¹, Daniel Bahat¹, Christopher Jou¹

¹Plastic Surgery, Cleveland Clinic, Cleveland, USA.

|March 4, 2026

Summary

Transgender patients had similar surgical outcomes after upper extremity procedures compared to cisgender patients, despite higher rates of mental health conditions. This suggests transgender status is not a risk factor for adverse surgical outcomes.

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Area of Science:

Orthopedic surgery
Transgender health
Psychosocial outcomes

Background:

Transgender individuals face higher mental health burdens, potentially affecting surgical recovery.
Limited data exists on postoperative outcomes for transgender patients undergoing upper extremity surgery.
Psychosocial factors significantly influence recovery and pain perception in orthopedic surgery.

Purpose of the Study:

To compare clinical and psychosocial outcomes in transgender versus cisgender patients after hand and upper extremity surgery.
To investigate potential disparities in surgical results based on gender identity.

Main Methods:

Retrospective chart review of patients from 2015-2023.
Identification of transgender patients via ICD-9/10 codes for gender dysphoria.

Keywords:

outcomes surgery transgender trauma upper extremity

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Matching transgender patients with cisgender controls.

Main Results:

No significant differences in complication rates, re-operation, infection, or hardware failure between groups.
Transgender patients had significantly higher rates of psychiatric diagnoses (71.4% vs. 35.3%).
Mean PHQ-9 scores, indicating depression severity, were similar between transgender and cisgender patients.

Conclusions:

Transgender patients achieve comparable postoperative outcomes to cisgender patients after upper extremity surgery.
Transgender status should not be considered an independent risk factor for adverse surgical outcomes.
Further research is needed to explore the interplay of gender identity, mental health, and surgical recovery.