Barriers To Finding A Gender Affirming Surgeon

Cohen, Wess A.; Maisner, Rose S.; Mansukhani, Priya A.; Keith, John A.

doi:10.1007/s00266-020-01883-z

Cited by 39 publications

(23 citation statements)

References 11 publications

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“…Even before the pandemic, availability of gender-affirming healthcare providers was limited in many parts of the U.S. (Cohen, Maisner, Mansukhani, & Keith, 2020). Additionally, insurance coverage for gender-affirming surgery varies by state and health insurance carrier (Padula & Baker, 2017).…”

Section: Access To Gender-affirming Medical Care During Covid-19mentioning

confidence: 99%

Understanding the Impact of the COVID-19 Pandemic on the Mental Health of Transgender and Gender Nonbinary Individuals Engaged in a Longitudinal Cohort Study

Kidd

Jackman

Barucco

et al. 2021

Journal of Homosexuality

109

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While the COVID-19 pandemic in the United States disproportionately impacts marginalized communities, no empiric US-based research has focused specifically on transgender and gender nonbinary (TGNB) people. We examined the pandemic's impact on an established longitudinal cohort of TGNB individuals (N = 208) by administering an online survey between March-June 2020. We used multivariable linear regression to examine reduced LGBTQ/TGNB community support and disruptions in gender-affirming health care as predictors of psychological distress during the pandemic. We found that the pandemic exacerbated ongoing mental health disparities for TGNB individuals. Furthermore, reduced LGBTQ/TGNB support was associated with increased psychological distress during the pandemic. Interruption and/or delay in gender-affirming health care was not associated with increased psychological distress during the pandemic. Special attention is needed to address the unique ways in which TGNB individuals were affected by the COVID-19 pandemic. This includes increasing access to LGBTQ/TGNB community support and addressing long-standing health disparities.

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Section: Access To Gender-affirming Medical Care During Covid-19mentioning

confidence: 99%

Understanding the Impact of the COVID-19 Pandemic on the Mental Health of Transgender and Gender Nonbinary Individuals Engaged in a Longitudinal Cohort Study

Kidd

Jackman

Barucco

et al. 2021

Journal of Homosexuality

109

View full text Add to dashboard Cite

show abstract

“…An additional consideration is geographic accessibility of physician practices offering GABS. Recent studies show that most physicians offering GABS are geographically concentrated in metropolitan areas, with greater than 55% practicing in Northeastern and West Coast states 28 . In addition, 47% of American states did not have a physician practice offering GABS 29 .…”

Section: Discussionmentioning

confidence: 99%

A Critical Assessment of the Transgender Health Care Workforce in the United States and the Capacity to Deliver Gender-Affirming Bottom Surgery

et al. 2022

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Background: Gender-affirming surgery is a critical component of transgender health care, but access information is limited. The study aim was to assess workforce capacity to perform gender affirming bottom surgeries (GABSs) in the United States. Methods: A questionnaire was administered via email, phone call, or fax from February to May 2020 to 86 practices identified as performing GABS by searching 10 Web-based databases with standardized keywords. Questions assessed training capacity, surgical capacity, and surgeon experience. Results: Thirty-two of 86 practices responded, 20 met the inclusion criteria. Practices were identified in 15 states, with an average 2.4 (SD, 1.3) surgeons performing GABS per year. States with the greatest number of total providers offering GABS were Illinois (n = 21), Texas (n = 10), and Massachusetts (n = 13). No significant correlation between number of GABS types offered and geographic population density (r = −0.40, P = 0.08), or between number of providers and geographic population density (r = 0.19, P = 0.44). Vaginoplasty was most frequently performed, with the longest waitlists and highest number of waitlist additions per month. Phalloplasty was the second most common procedure, and waitlist additions per month exceeded provider capacity to perform the procedure. Most surgeons performing GABS were plastic surgeons and urologists, whereas obstetricians/gynecologists performed the majority of hysterectomies. Conclusions: This study demonstrated a shortage of providers with requisite training and experience to provide GABS. Although more robust studies are needed to better characterize the relationship between the number of patients seeking GABS and available providers, these findings indicate a need for improved training.

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“…Access to the ideal surgeon for a given individual patient is challenging. There are currently only 660 surgeons who perform GAS across the USA, mostly plastic surgeons, to care for the over one million estimated patients with gender dysphoria [ 4 , 5 ]. One must also navigate issues such as the geographical constraints on surgeon availability, long waiting lists for surgical consultations and/or surgical time, varying insurance coverage, and finding a surgeon one can truly entrust such a highly personal and life-altering procedure [ 4 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Selecting a chest masculinization plastic surgeon: a survey of transgender patients

et al. 2023

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Background Chest masculinization is a commonly performed gender-affirming procedure in transmasculine and non-binary patients and has increased in prevalence in recent years despite continued barriers to surgical care. With the expansion of insurance coverage and trained surgeons, patients at times have the opportunity to be selective in choosing their gender-affirming surgeon. This study aimed to investigate factors that transmasculine individuals consider important when selecting their chest masculinization plastic surgeon. Methods All patients who underwent chest masculinization with a single surgeon between January 2018 and December 2021 were surveyed via an online questionnaire to rate 21 factors associated with surgeon selection. Multiple-choice questions and free text space were included to further clarify patient preferences. Results were analyzed to rate factors in order of importance. Results One hundred three individuals completed the survey, generating a response rate of 49.5%. Average patient age at time of surgery was 27.0 years, and 2.0% of patients had prior gender affirmation surgery (GAS). The top five most important factors were surgeon specialization in GAS, insurance coverage, board certification, number of times surgeon has performed procedure, and availability of Before and After photographs. The five least important factors were age of surgeon, medical publications, availability of YouTube videos, location of training, and surgeon presence on social media. Conclusions Transmasculine patients employ distinct criteria when selecting a chest masculinization gender-affirming plastic surgeon. An improved understanding of these factors informs providers of ways to enhance patient access to information and gender-affirming care. Level of evidence: Not gradable.

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Barriers To Finding A Gender Affirming Surgeon

Cited by 39 publications

References 11 publications

Understanding the Impact of the COVID-19 Pandemic on the Mental Health of Transgender and Gender Nonbinary Individuals Engaged in a Longitudinal Cohort Study

Understanding the Impact of the COVID-19 Pandemic on the Mental Health of Transgender and Gender Nonbinary Individuals Engaged in a Longitudinal Cohort Study

A Critical Assessment of the Transgender Health Care Workforce in the United States and the Capacity to Deliver Gender-Affirming Bottom Surgery

Selecting a chest masculinization plastic surgeon: a survey of transgender patients

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