Gender Affirming Top Surgery In Transmale Vs. Gender Nonconforming Patients - Does Gender Identity Affect Patient-reported Outcomes?
Emmeline Jia, MS1, Sivana Barron, BA1, Christine Kang, MD, MHS, MS1, Monica Morgenstern, MS1, Valeria Bustos, MD, MSc1, Carolina Torres, MD1, Brianna Slatnick, MD2, Amy Maselli, MD1, Bernard Lee, MD, MBA, MPH, FACS1, Adam Tobias, MD1, Ryan Cauley, MD, MPH1.
1Beth Israel Deaconess Medical Center, Boston, MA, USA, 2Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
PURPOSE: Masculinizing chest reconstruction in the transmale and gender non-binary patient populations is integral in treatment of gender dysphoria. The present study sought to evaluate the effect of gender identity on clinical and patient reported post-operative outcomes (PROs) following chest masculinization surgery.
METHODS: Patients who underwent double-incision subcutaneous gender-affirming mastectomies within one institution (2014-2019) were queried, demographics, surgical and post-operative variables were collected and PROs were obtained using a validated metric (BODY-Q scales, Q-portfolio). Patients were stratified according to gender identity: Transgender Male (n=130), Non-Binary (n=13), and Other (n=10). Univariate analysis was performed.
RESULTS: Of the 153 complete responders, 85% identified as transgender male, 8.5% as non-binary, and 6.5% as another gender identity. Patients identifying as non-binary or another gender identity were significantly less likely to be on pre-operative hormone therapy (p=<0.001). Otherwise, demographic and pre-operative variables were similar across the groups. No statistical difference was found in post-operative complications. Overall satisfaction was similar across groups but there was a trend towards lower nipple satisfaction in non-binary individuals (Table 1).
CONCLUSION: Gender identity is a non-modifiable risk factor, but remains an unknown variable for clinical and PROs following chest masculinization. We found no significant difference in post-operative complications between transmen, non-binary individuals, or other gender-identifying individuals and high post-operative satisfaction was seen in all groups. 
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