Gender-Affirming Surgeries in Transmasculine People: An Individualized Decision [27M]

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 133 Suppl 1; no. 1; p. 148S
• Main Authors: Abern, Lauren, Cook, Jake, Maguire, Karla
• Format: Journal Article
• Language: English
• Published: by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved 01.05.2019
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/01.AOG.0000559300.38480.14

INTRODUCTION:The process of transitioning is a journey unique to each transgender individual. While many wish to obtain various gender-affirming surgeries and face many barriers in that process, some do not desire surgery to transition. The goal of this study is to determine if transmasculine people underwent gender-affirming surgery, reasons for not proceeding with surgery, and barriers experienced. METHODS:Transmasculine people ages 18-64 participated in an online survey which included demographics, surgical history, reasons for not obtaining surgery, and barriers to care. RESULTS:781 individuals participated. The mean age was 27 (SD 8.6). The majority was white (663, 85%) and had a college degree (344, 44%). 530 had private insurance (68%), and 413 (53%) made less than $24,000/year. 468 (60%) were on hormone therapy. 289 (37%) underwent a form of gender-affirming surgery. 357 (73%) plan to do so in the future. 262 (54%) have not had surgery due to financial reasons, and 112 (23%) as a result of insurance difficulties. 61 (13%) do not plan on having surgery, and 23 (5%) are uncertain. 61 (13%) risk losing family support if proceeding with surgery. If cost was covered, 239 (32%) said they would not proceed with bottom surgery while 242 (32%) were unsure. CONCLUSION:The decision to proceed with various gender-affirming surgeries is individualized, with people desiring none, some, or all surgical options. Barriers including insufficient finances and lack of insurance coverage make it difficult for those that desire surgery, despite many having private insurance. This is important to consider when counseling about transition-related care.