Masculinizing Chest Reconstruction in Transgender and Nonbinary Individuals: An Analysis of Epidemiology, Surgical Technique, and Postoperative Outcomes

Cuccolo, Nicholas G.; Kang, Christine O.; Boskey, Elizabeth R.; Ibrahim, Ahmed M. S.; Blankensteijn, Louise L.; Taghinia, Amir H.; Lee, Bernard T.; Lin, Samuel J.; Ganor, Oren

doi:10.1007/s00266-019-01479-2

Cited by 37 publications

(38 citation statements)

References 46 publications

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“…[33][34][35] Involving behavioral health providers in the surgical care team provides an additional opportunity to routinely assess these behaviors and engage patients with harm reduction interventions, for which time may not be available during the medical visit. Although many surgeons set a minimum body mass index (BMI) because of the association between BMI and postsurgical complications, 8,36 our Center does not, as many of our patients have difficulty participating in exercise and other weight loss activities due to the limitations caused by their chests.…”

Section: Discussionmentioning

confidence: 99%

“…5 Chest surgery in trans-masculine individuals usually takes the form of chest reconstruction, although some nonbinary individuals choose breast reduction instead. 8 Chest reconstruction is a surgical procedure that is used to eliminate the breasts and create a more masculine chest contour. This surgery is considered to be medically necessary for individuals experiencing significant chest dysphoria in the context of gender dysphoria.…”

Section: Introductionmentioning

confidence: 99%

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Behavioral Health Concerns and Eligibility Factors Among Adolescents and Young Adults Seeking Gender-Affirming Masculinizing Top Surgery

et al. 2020

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Purpose: We evaluated behavioral health histories and eligibility factors for patients seeking chest reconstruction. Methods: One hundred and fifty-eight consecutive transgender patients were seen for initial masculinizing top surgery consults between May 2017 and July 2019. Chart review was used to assess behavioral health and demographic factors, and eligibility factors related to the World Professional Association for Transgender Health (WPATH) Standards of Care. Univariate and age-adjusted regression models were used to examine the relationship between demographic and behavioral health factors and WPATH criteria. Results: The average age of patients at the time of their first consult was 18 (standard deviation = 3.3, range = 14-33). Eighty-five percent had at least one behavioral health diagnosis; 27% had three or more. Sixty-four percent endorsed a history of self-harm or suicidal ideation, 13% within the last 6 months. Thirty-two percent reported a history of marijuana use and 19% a history of nicotine use. For those prescribed testosterone, additional months on testosterone were significantly associated with male (vs. nonbinary) gender (b = 4.64, 95% confidence interval [CI] 0.37-8.90, p = 0.033), age (b = 0.87, 95% CI 0.41-1.34, p < 0.001), living as one's affirmed gender for over 1 year (b = 6.37, 95% CI 1.37-11.37, p = 0.013), history of marijuana use (b = 4.54, 95% CI 1.10-7.98, p = 0.010), and history of nicotine use (b = 6.23, 95% CI 2.22-10.26, p = 0.003). Conclusion:Patients seeking gender-affirming masculinizing top surgery are behaviorally complex, in ways not necessarily associated with surgical eligibility. Involving a behavioral health provider in perioperative assessment can help identify and address potential risks to recovery and outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Behavioral Health Concerns and Eligibility Factors Among Adolescents and Young Adults Seeking Gender-Affirming Masculinizing Top Surgery

et al. 2020

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“…29 , 30 The most common postoperative complications are bleeding, infection, fluid collection, and wound healing problems, including NAC graft failure. 31 Scars can change as an AYA grows or undergoes weight changes, and can also undergo pigmentation changes. Patients with scar concerns should be referred to their surgeon or another plastic surgeon specializing in chest reconstruction.…”

Section: Chest Reconstructionmentioning

confidence: 99%

Gender-Affirming Surgeries in Transgender and Gender Diverse Adolescent and Young Adults: A Pediatric and Adolescent Gynecology Primer

Grimstad

Boskey

Taghinia

et al. 2021

Journal of Pediatric and Adolescent Gynecology

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“…69,70 Initial postoperative complications include bleeding, infection, fluid collection, and wound-healing problems. 71 Long-term complications typically include esthetic concerns related to the appearance of scars, as they can change with weight fluctuation and as an individual grows. Patients concerned about scar formation can be either referred to the original surgeon or another plastic surgeon specializing in chest reconstruction.…”

Section: Chest Reconstructionmentioning

confidence: 99%

Masculinizing Gender Affirming Surgery

El-Arabi

Barrera

McLaren

et al. 2021

Journal of Gynecologic Surgery

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For many transgender individuals, pursuing gender-affirming surgery (GAS) to minimize gender incongruencecommonly referred to as gender dysphoria-is a medically necessary element of comprehensive genderaffirming health care. Patients who undergo GAS report high postoperative satisfaction rates, and research indicates that GAS improves quality of life and emotional well-being, and eases gender dysphoria. This article is 1 of several articles in the current issue, summarizing the available surgical interventions for alleviating gender incongruence among transgender patients. This part briefly reviews and examines surgical aspects of masculinizing GAS for transmasculine patients.

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Masculinizing Chest Reconstruction in Transgender and Nonbinary Individuals: An Analysis of Epidemiology, Surgical Technique, and Postoperative Outcomes

Cited by 37 publications

References 46 publications

Behavioral Health Concerns and Eligibility Factors Among Adolescents and Young Adults Seeking Gender-Affirming Masculinizing Top Surgery

Behavioral Health Concerns and Eligibility Factors Among Adolescents and Young Adults Seeking Gender-Affirming Masculinizing Top Surgery

Gender-Affirming Surgeries in Transgender and Gender Diverse Adolescent and Young Adults: A Pediatric and Adolescent Gynecology Primer

Masculinizing Gender Affirming Surgery

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