Transmasculine patients' perspective before and after genital gender-affirming surgery

Gender-affirming care aims to reduce gender-related distress. Informational needs regarding masculinizing genital gender-affirming surgery (GGAS) remain poorly understood. We conducted a cross-sectional survey, inviting transmasculine individuals who had undergone phalloplasty or metoidioplasty. Participants rated the importance of specific topics on a 1-5 Likert scale before, during, and after surgery, reported the information they received and identified sources and preferred delivery formats. Forty-four patients were included (response rate 48.4%). Before surgery, the topics deemed of high importance (4 or 5) were possible complications, preparation of the donor site, long-term follow-up and complications and differences between surgical techniques (all 100%); written materials were the preferred format (87.5%). Participants reported important informative gaps (% importance high - %coverage), particularly regarding the management of ischemic complications (62.0%), urethral fistula (33.0%) or stenosis (32.0%), financial costs (35.0%), and the need for a structured support plan after surgery (22.0%). During hospitalization, respectful communication (95.4%), nursing experience with GGAS (100%), and clear instructions for self-care at discharge (97.7%) were deemed to be of high importance (4 or 5). In follow-up, patients emphasized guidance on prevention of injury to the neophallus (97.7%) and criteria for unscheduled visits (93.2%). These findings highlight the need for comprehensive, written, team-based counselling, and structured continuity of care to align surgical services with patient priorities.