Patient-reported outcomes following chest masculinization surgery in transmasculine individuals: A prospective study

Chest masculinization surgery is a cornerstone of gender-affirming care for transmasculine individuals, with well-documented benefits on body image and quality of life. However, prospective data using validated patient-reported outcome measures (PROMs) remain limited.

This prospective longitudinal study was conducted in accordance with the STROBE guidelines. Adult transmasculine patients undergoing chest masculinization surgery at Hôpital Saint-Louis (Paris, France) between April 2022 and October 2024 were invited to complete the BODY-Q questionnaire preoperatively and at 6 months postoperatively. Demographic, morphological, and surgical variables were collected. Pre-post comparisons were performed, and associations between outcomes and covariates were explored.

Forty-four transmasculine patients met the inclusion criteria. Mean age at surgery was 24.1 ± 5.6 years. Significant improvements were observed across all BODY-Q appearance and health-related quality-of-life domains (all P < 0.0001). For example, chest satisfaction increased from 24.0% ± 16.0% to 82.0% ± 18%, and psychological well-being from 24.0% ± 22.0% to 62.0% ± 19%. No statistically significant associations were identified between postoperative BODY-Q scores and surgical technique, BMI, or demographic variables; however, these findings should be interpreted with caution given the limited sample size. Postoperative expectations remained stable, suggesting realistic preoperative counseling.

Chest masculinization surgery was associated with marked improvements in appearance-related satisfaction and health-related quality of life at 6 months. Despite limitations related to sample size, response rate, and follow-up duration, these findings support the substantial positive impact of this procedure on patient-reported outcomes in transmasculine individuals.