Assessing Quality of Life and Patient-Reported Satisfaction with Masculinizing Top Surgery: A Mixed-Methods Descriptive Survey Study

Abstract

Background: Masculinizing top surgery (bilateral mastectomy with chest wall reconstruction) is an important gender-affirming procedure sought by many transmasculine and nonbinary individuals. Current literature is focused primarily on details of surgical technique and complication rates, with limited data available on how top surgery affects subjective quality-of-life measures. Methods: An anonymous online survey was distributed to 81 of the senior author’s former top-surgery patients. The survey response rate was 72 percent (58 respondents). Responses were analyzed to investigate quality of life, sexual confidence, mental health, satisfaction with top surgery, and patient attitudes toward top surgery’s role in gender affirmation. Results: Following top surgery, measures of quality of life and sexual confidence improved significantly (p < 0.001). In addition, 86 percent reported improvement in gender dysphoria–related mental health conditions. All but one respondent reported that top surgery had an overall positive impact on their life. Conclusions: Top surgery had major positive effects on all mental health and quality-of-life metrics. The authors’ findings contribute to a much-needed body of evidence that top surgery markedly improves the daily lives and functioning of transgender and nonbinary individuals who choose to undergo it.

Hockey stick incision: a modified technique for chest wall masculinization

“…These considerations were not accounted for in the BODY-Q module (34)(35)(36)(37)(38). This also underscores the fact that the appropriate reconstructive considerations are highly individualized, and that satisfaction is not necessarily a function of exclusively objective variables (10,11,13).…”

Transgender pediatric surgical patients—Important perioperative considerations

“…Genital surgeries are also sometimes performed earlier outside of the recommendations on a case‐by‐case basis 27,28 . Importantly, surgeries for transgender individuals are medically necessary procedures, proven to improve dysphoria, mental health, and quality of life, 26,29‐33 and should not be viewed as elective 14,15 …”

Dermatologic Care of Hair in Transgender Patients: A Systematic Review of Literature

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