Study finds gender-affirming surgeries nearly tripled from 2016 to 2019

According to a study published Wednesday on JAMA Network Open, gender-affirming surgeries (GAS) were found to have spiked during the pre-pandemic years.

The study, conducted jointly by Columbia University and the University of Southern California, examined 48,019 patients tracked between 2016 and 2020. It revealed that the number of surgeries nearly tripled from 4,552 in 2016 to 13,011 in 2019. This upward trend was interrupted when the pandemic hit in 2020, leading to the postponement and suspension of many non-emergency operations.

For the purposes of the study, gender-affirming surgeries included procedures such as facial reconstruction, top surgery, and bottom surgery (a.k.a. genital reconstruction). Top surgeries were the most common, with 27,187 of the tracked patients undergoing them. Bottom surgeries were the second most common, increasing with the age of patients.

Young adults ages 19-30 made up the majority of GAS patients. Meanwhile, minors 12-18 – a group which has seen considerable restrictions on gender-affirming care pushed by conservative lawmakers in several states – only accounted for about 7.7 percent, fewer than 1,200, “even in the highest volume years.” Overall, the average age at which patients began treatments to transition was 23 for transgender men and 27 for trans women.

More than half of patients received coverage through private health insurance, while a quarter were covered by Medicaid, reflecting the increasingly strong range offered by insurers.

“More patients have had access to these procedures,” said Dr. Jason D. Wright, the study’s lead author. “Not only are most of these procedures very safe from a complication standpoint but they’re also associated with favorable outcomes with relatively high rates of patient satisfaction.”

“The rapid rise in the performance of GAS suggests that there will be a greater need for clinicians knowledgeable in the care of transgender individuals and with the requisite expertise to perform GAS procedures,” the study concluded. “Despite many medical societies recognizing the necessity of gender-affirming care, several states have enacted legislation or policies that restrict gender-affirming care and services, particularly in adolescence.”

“These regulations are barriers for patients who seek gender-affirming care and provide legal and ethical challenges for clinicians. As the use of GAS increases, delivering equitable gender-affirming care in this complex landscape will remain a public health challenge.”

(Photo courtesy of Ted Eytan | CC BY-SA 2.0)


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