Margulies Ilana G, Chuang Carolyn, Travieso Roberto, Zhu Victor, Persing John A, Steinbacher Derek M, Zellner Elizabeth G
From the New York Medical College, Valhalla, NY.
Yale University School of Medicine, New Haven, CT.
Ann Plast Surg. 2021 Jan;86(1):82-88. doi: 10.1097/SAP.0000000000002351.
Increased awareness for transgender and gender-nonconforming individuals may lead to increased demand for surgical interventions in gender-confirming care. However, limited literature exists regarding transgender and gender-nonconforming preferences and experiences with medical or surgical care. The authors aim to characterize the medical and surgical care sought by this population, as well as their surgical preferences, motivations, and barriers to care.
An online questionnaire about opinions and personal experiences with medical and surgical care during gender transition was publicized via regional online social networking forums in Connecticut and surrounding areas catering to transgender communities.
Responses were received from 313 participants. Participants were 97% male gender at birth and 92% white with an average (SD) age of 51.6 (13.5) years. Fifty-nine percent identified as male-to-female transgender and 20% as gender nonconforming. Respondents were aware of their gender identity at a mean (SD) age of 9.6 (9.0) years, but did not begin transitioning until a mean (SD) age of 38.9 (20.8) years, with gender-nonconforming respondents choosing to transition at a significantly younger age as compared with transgender respondents (29.8 vs 41.4 years; P = 0.0061, unpaired t test). Only 42% of all respondents, with a significantly greater number of transgender as opposed to gender-nonconforming individuals, had previously met with a physician to discuss transitioning (49% vs 21%, P = 0.002, χ test). Eight percent of the study population had undergone gender confirmation surgery (GCS), 52% were interested in GCS, and 40% were not interested in GCS. Primary motivation for GCS included discomfort in one's current body (28%), and barriers to GCS included cost (40%) and reactions of family (40%), partners (32%), and friends (25%).
Transgender and gender-nonconforming individuals lack medical support for gender transition, with fewer than half of survey respondents reporting a prior meeting with a physician to discuss transitioning. The reported perspectives offer important insight into transgender preferences that should act as the basis of future efforts to improve the efficacy of gender-confirming care.
对跨性别者和性别认同不符者的关注度提高，可能会导致性别确认治疗中手术干预的需求增加。然而，关于跨性别者和性别认同不符者在医疗或手术治疗方面的偏好和经历的文献有限。作者旨在描述该人群寻求的医疗和手术治疗，以及他们的手术偏好、动机和治疗障碍。
通过康涅狄格州及周边地区面向跨性别群体的在线社交网络论坛，公布了一份关于性别转换期间医疗和手术治疗的意见及个人经历的在线问卷。
共收到313名参与者的回复。参与者出生时97%为男性，92%为白人，平均（标准差）年龄为51.6（13.5）岁。59%的人认定为男变女跨性别者，20%的人认定为性别认同不符者。受访者意识到自己的性别认同的平均（标准差）年龄为9.6（9.0）岁，但直到平均（标准差）年龄38.9（20.8）岁才开始转变，与跨性别受访者相比，性别认同不符的受访者选择转变的年龄要小得多（分别为29.8岁和41.4岁；P = 0.0061，独立样本t检验）。在所有受访者中，只有42%的人（跨性别者的数量明显多于性别认同不符者）曾与医生会面讨论转变事宜（49%对21%，P = 0.002，χ检验）。8%的研究人群接受过性别确认手术（GCS），52%的人对GCS感兴趣，40%的人对GCS不感兴趣。GCS的主要动机包括对自己当前身体的不适感（28%），GCS的障碍包括费用（40%）以及家人（40%）、伴侣（32%）和朋友（25%）的反应。
跨性别者和性别认同不符者在性别转换方面缺乏医疗支持，不到一半的受访者表示曾与医生会面讨论转变事宜。所报告的观点为跨性别者的偏好提供了重要见解，应作为未来提高性别确认治疗效果努力的基础。
