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General Health And Psychosocial Functioning After Facial Feminization Surgery - A Nationwide Cross-sectional Analysis Of The Transpop Study
Rishub Karan Das, MD, Brian C. Drolet, MD, Salam Al Kassis, MD, Galen Perdikis, MD.
Vanderbilt University Medical Center, Nashville, TN, USA.
PURPOSE: Facial feminization surgery (FFS) uses craniomaxillofacial techniques to feminize the face which can alleviate gender dysphoria in gender diverse individuals. However, insurance coverage for these procedures is variable due to limited evidence on health and psychosocial outcomes after FFS. We used the TransPop Study, the first nationally representative US transgender population health survey, to evaluate the influence of FFS on general health and validated metrics of psychosocial functioning.
METHODS: A cross-sectional analysis of the TransPop Study was conducted in line with STROBE guidelines. Outcomes of interests included demographics, health status, and validated measures of psychological distress and well-being. Sociodemographic and outcome differences between the FFS and non-FFS groups were evaluated using weighted Pearson χ² tests with Rao-Scott correction, with an α < 0.05.
RESULTS: Among 144 gender diverse individuals assigned male at birth, 5.7% (95% CI, 2.9%-11.0%) reported having FFS. FFS participants were more likely to have completed college and graduate school (p<0.001) and receive other gender-affirming care including hormone therapy (p<0.001) and gender-affirming chest reconstruction (p<0.001). The FFS group had significantly lower rates of serious psychological distress (8.0% vs. 38.2%,
p<0.05). Life satisfaction was higher in the FFS group (85.3% vs. 28.6%, p<0.001), as was self-reported general health (96.4% vs. 79.0; p<0.05).
CONCLUSION: Based on this nationally representative study, FFS was associated with improved general health, psychological distress, and life satisfaction. These findings underscore the need for policies, training opportunities, and insurance coverage that enhance access to FFS for individuals with gender dysphoria
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