Most trans patients don't undergo gender-affirming surgeries

Turns out, transgender patients don't opt for gender-affirming surgeries as much as many believe.

The researchers from Boston Medical Center (BMC) conducted the first study in the U.S. to determine the prevalence of gender-affirming surgeries among a defined group of transgender patients and found that most patients did not elect to have surgery.

The study looked at 99 transgender patients who were undergoing hormone therapy at BMC, the majority transwomen. Data was collected from years prior to 2015, before Massachusetts required all insurers to cover medically necessary care related to gender transition, like gender affirming surgeries.

Only 35 percent of patients chose to undergo any form of gender affirming surgery, with only 15 percent undergoing genital surgery. Transmen were twice as likely to have surgery as transwomen, with more than half of transmen choosing to have chest surgery and far fewer choosing genital surgery. Transwomen were equally or less likely to undergo genital surgery than facial feminization or chest surgery.

Lead author Joshua Safer noted that before 2015, there was a much higher financial cost associated with this surgery. "While accessibility has increased in the past decade, we still see a shortage of surgeons who perform gender affirming surgeries, and the data we have is limited."

The researchers speculated that there will be an increase in gender-affirming surgeries in the future, and point to the need for better provider education in transgender medicine and further studies looking into how insurance coverage changes impact the number of transgender patients seeking out gender affirmation surgery.

The study is published online in Endocrine Practice.