What is “Nonbinary” and What Do I Need to Know? A Primer for Surgeons Providing Chest Surgery for Transgender Patients

Esmonde, Nick O.; Heston, Aaron L.; Jedrzejewski, Breanna; Ramly, Elie P.; Annen, Alvin W.; Guerriero, Jess; Hansen, Juliana E.; Berli, Jens U.

doi:10.1093/asj/sjy166

Cited by 23 publications

(23 citation statements)

References 23 publications

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“…Only one study addressing health outcomes related to medical interventions for NBGQ individuals was found. Among 458 patients undergoing gender-affirming chest surgery, Esmonde et al (2018) found that 13% ( N = 58) were NBGQ, all FAAB. Among them, 56% ( N = 33) completed the post-operative questionnaire.…”

Section: Resultsmentioning

confidence: 99%

“…Finally, the only study analyzing the effects of medical interventions on health of NBGQ individuals (i.e., third research question) found that NBGQ FAAB individuals, contrary to the belief that they would not need to medically affirm their gender, improved their quality of life and health after chest surgery (Esmonde et al, 2018). This result is in line with previous studies which found that both hormonal treatment (e.g., Newfield et al, 2006) and chest surgery (e.g., Agarwal et al, 2018) commonly improved the quality of life and well-being of female-to-male transgender individuals.…”

Section: Discussionmentioning

confidence: 99%

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Health of Non-binary and Genderqueer People: A Systematic Review

et al. 2019

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Background: Non-binary and genderqueer (NBGQ) people are those who do not identify within the gender binary system (male vs. female), not falling exclusively in man/male or woman/female normative categories. A higher proportion of NBGQ people is usually found within young persons. This population is marginalized and, as such, is at risk of stigmatization and of developing negative health outcomes. As literature on the health of NBGQ people is sparse, this study aims at systematically review the limited studies on this field. Methods: The research questions which guided the systematic review were: (1) What are the differences in the health levels between NBGQ and binary transgender (BT) individuals? (2) What are the differences in the health levels between NBGQ and cisgender individuals? (3) Which medical and psychological interventions are most suitable for improving NBGQ health? According to PRISMA guidelines, a systematic search was conducted in PubMed, PsycInfo, Web of Science, and Google Scholar. Results: Eleven studies met the inclusion criteria for the current systematic review. Among them, 9 were focused on the health differences between NBGQ and BT individuals, 4 of the latter and 1 individually were focused on the health differences between NBGQ and cisgender individuals, and 1 was focused on the evaluation of health outcomes related to medical procedures. No studies assessed psychological interventions aimed at improving health in NBGQ individuals. All studies were cross-sectional, did not generally recruit a large sample of NBGQ individuals, and used non-probability sample design. Results related to the difference in health between NBGQ and BT were mixed; indeed, some found a better health status while others a worse one. Results related to the differences in health between NBGQ and cisgender highlighted higher health needs in NBGQ than in BT individuals. The only study analyzing the effects of medical interventions on health found that NBGQ female-assigned at birth individuals improved their quality of life after chest surgery. Conclusions: Although scholars are starting to pay attention to the NBGQ health, research needs to be expanded both in terms of methodology and research contents. Clinical, health-related social policies, and research recommendations in this field are reported.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Health of Non-binary and Genderqueer People: A Systematic Review

et al. 2019

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“…Reduction of dysphoria, improvement of body image and confidence following mastectomy affected sexual relationships positively. 38,183,184 Removal of the Female Sexual Organs Evidence. Indications for hysterectomy include persistent blood loss, dysphoric feelings, unwanted discharge or lubrication, and within the context of GAS with urethral lengthening.…”

Section: Surgical Procedures For Masculinizing Gasmentioning

confidence: 99%

“…Reduction of dysphoria, improvement of body image and confidence following mastectomy affected sexual relationships positively. 38 , 183 , 184 …”

Section: Surgical Procedures For Masculinizing Gasmentioning

confidence: 99%

ESSM Position Statement “Sexual Wellbeing After Gender Affirming Surgery”

et al. 2021

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Introduction: Much has been published on the surgical and functional results following Gender Affirming Surgery ('GAS') in trans individuals. Comprehensive results regarding sexual wellbeing following GAS, however, are generally lacking. Aim: To review the impact of various GAS on sexual wellbeing in treatment seeking trans individuals, and provide a comprehensive list of clinical recommendations regarding the various surgical options of GAS on behalf of the European Society for Sexual Medicine. Methods: The Medline, Cochrane Library and Embase databases were reviewed on the results of sexual wellbeing after GAS. Main Outcomes Measure: The task force established consensus statements regarding the somatic and general requirements before GAS and of GAS: orchiectomy-only, vaginoplasty, breast augmentation, vocal feminization surgery, facial feminization surgery, mastectomy, removal of the female sexual organs, metaidoioplasty, and phalloplasty. Outcomes pertaining to sexual wellbeing-sexual satisfaction, sexual relationship, sexual response, sexual activity, enacted sexual script, sexuality, sexual function, genital function, quality of sex life and sexual pleasureare provided for each statement separately. Results: The present position paper provides clinicians with statements and recommendations for clinical practice, regarding GAS and their effects on sexual wellbeing in trans individuals. These data, are limited and may not be sufficient to make evidence-based recommendations for every surgical option. Findings regarding sexual wellbeing following GAS were mainly positive. There was no data on sexual wellbeing following orchiectomyonly, vocal feminization surgery, facial feminization surgery or the removal of the female sexual organs. The choice for GAS is dependent on patient preference, anatomy and health status, and the surgeon's skills. Trans individuals may benefit from studies focusing exclusively on the effects of GAS on sexual wellbeing. Conclusion:The available evidence suggests positive results regarding sexual wellbeing following GAS. We advise more studies that underline the evidence regarding sexual wellbeing following GAS. This position statement may aid both clinicians and patients in decision-making process regarding the choice for GAS. M€ ujde € Ozer, Sahaand Poor Toulabi, Alessandra D. Fisher, et al. ESSM Position Statement "Sexual Wellbeing After Gender Affirming Surgery". Sex Med 2021;XX:XXXXXX.

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“…The US Transgender Survey (2015) reported that only 25% of 27, 000 respondents had undergone a gender-affirming surgery [3]. Additionally, people with non-binary identities may not identify as either a man or a woman and may undergo gender-affirming surgery [4].…”

Section: Introductionmentioning

confidence: 99%