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Gender-affirming Chest Reconstruction Improves Psychological Distress, Life Satisfaction, And Societal Acceptance - 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: The TransPop Study is the first nationally representative US transgender population health survey conducted by the Williams Institute at UCLA School of Law, Columbia University, Harvard University, and The Fenway Institute at Fenway Health. Using this data, we evaluated the demographics, health outcomes, and well-being of gender diverse individuals undergoing gender-affirming chest reconstruction (GACR).
METHODS: A cross-sectional analysis of the TransPop Study was conducted in line with STROBE guidelines. Outcomes of interests included demographics, health status, family support, and validated measures of psychological distress and well-being. Sociodemographic and outcome differences between the GACR and non-GACR groups were evaluated using weighted Pearson χ² tests with Rao-Scott correction, with an α < 0.05.
RESULTS: Among 274 gender-diverse individuals, 53 (15.0%; 95% CI, 10.6%-20.9%) reported having GACR. GACR participants were more likely to be assigned female at birth (p<0.001) and use gender-affirming hormone therapy (p<0.001). The GACR group had significantly lower rates of serious psychological distress (13.3% vs. 43.4%, p<0.001). Perceived gender alignment ("passing") was higher in the GACR group (80.7% vs. 53.1%, p=0.01), as was life satisfaction (57.8% vs. 24.9%, p<0.001). Experiences of non-affirmation were less frequent in the GACR group (9.0% vs. 31.9%, p=0.002).
CONCLUSION: Our results are the first nationally representative data indicating that GACR is associated with improved validated measures of mental health outcomes, higher life satisfaction, and greater social acceptance. These findings underscore the need for policies that enhance access to GACR for individuals with gender dysphoria.
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