Assistant professor of nutrition at Saint Louis University in St Louis, Missouri.
Associate professor of pediatrics at Washington University School of Medicine's Division of Adolescent Medicine and co-director of the Washington University Transgender Center at St Louis Children's Hospital in Missouri.
AMA J Ethics. 2023 Jun 1;25(6):E398-406. doi: 10.1001/amajethics.2023.398.
Body mass index (BMI) cutoffs are routinely used to assess eligibility for gender-affirming surgeries (GAS), yet they are not empirically based. The transgender population is disproportionately affected by overweight and obesity due to clinical and psychosocial influences on body size. Strict BMI requirements for GAS are likely to cause harm by delaying care or denying patients the benefits of GAS. A patient-centered approach to assessing GAS eligibility with respect to BMI would utilize reliable predictors of surgical outcomes specific to each gender-affirming surgery, include measures of body composition and body fat distribution rather than BMI alone, center on the patient's desired body size, and emphasize collaboration and support if the patient genuinely desires weight loss.
体重指数（BMI）切点通常用于评估性别肯定手术（GAS）的资格，但它们没有经验依据。由于身体大小的临床和心理社会影响，超重和肥胖在跨性别人群中不成比例地受到影响。严格的 GAS BMI 要求可能会通过延迟护理或剥夺患者 GAS 的益处而造成伤害。一种以患者为中心的方法，根据 BMI 评估 GAS 的资格，将使用针对每种性别肯定手术的可靠手术结果预测因素，包括身体成分和体脂分布的测量，而不仅仅是 BMI，以患者期望的体型为中心，并强调协作和支持，如果患者真正希望减肥。
