From the Division of Plastic and Reconstructive Surgery (Bertrand, DeLong, McCleary, Nahabet, Slack, DaLio, Rudkin), University of California, Los Angeles, Los Angeles, CA.
Departments of Internal Medicine (Weimer, Bernacki), University of California, Los Angeles, Los Angeles, CA.
J Am Coll Surg. 2024 May 1;238(5):890-899. doi: 10.1097/XCS.0000000000000940. Epub 2024 Jan 31.
Limited literature exists examining the effects of gender-affirming mastectomy on transmasculine and nonbinary patients that is prospective and uses validated survey instruments.
The psychosocial functioning of transmasculine and nonbinary patients was compared between patients who underwent gender-affirming mastectomy and those who had not yet undergone surgery. Participants were enrolled in a single-site, combined study of surgical and psychosocial outcomes, including a cross-sectional cohort of preoperative and postoperative patients, as well as separate prospective cohort. Participants completed the BREAST-Q psychosocial and sexual well-being modules, the BODY-Q satisfaction with chest and nipples modules, the Body Image Quality of Life Inventory, the Transgender Congruence Scale, the Patient Health Questionnaire-9, and the Generalized Anxiety Disorder-7 scale before and after surgery. We also examined how patient demographic factors correlated with postoperative surgical and psychosocial outcomes.
A total of 111 transmasculine and nonbinary patients 18 to 63 years of age (mean ± SD 26.5 ± 8) underwent mastectomy and were included in the study. All were included in the cross-sectional cohort, and 20 were enrolled in the prospective cohort. More than one-third (34.2%) of patients were nonbinary. After surgery, psychosocial and sexual well-being, satisfaction, body image-related quality of life, and gender congruence were increased (p < 0.001) in both cohorts, and depression (p < 0.009 cross-sectional), and anxiety (p < 0.001 cross-sectional) were decreased. The most common adverse event was hypertrophic scarring, which occurred in 41 (36.9%) participants.
In this study of transmasculine and nonbinary adults, gender-affirming mastectomy was followed by substantial improvements in psychosocial functioning.
目前针对跨性别男性和非二元性别患者的性别肯定乳房切除术的影响，仅有少量的文献研究是前瞻性的，并使用了经过验证的调查工具。
本研究比较了已接受性别肯定乳房切除术的跨性别男性和非二元性别患者与尚未接受手术的患者的心理社会功能。参与者被纳入了一项单站点、手术和心理社会结果的联合研究，包括术前和术后患者的横断面队列，以及单独的前瞻性队列。参与者在手术前后完成了 BREAST-Q 心理社会和性健康模块、BODY-Q 胸部和乳头满意度模块、身体意象生活质量量表、跨性别一致性量表、患者健康问卷-9 和广泛性焦虑障碍-7 量表。我们还研究了患者人口统计学因素与术后手术和心理社会结果的相关性。
共有 111 名 18 至 63 岁（平均 ± 标准差 26.5 ± 8）的跨性别男性和非二元性别患者接受了乳房切除术，并纳入了本研究。所有患者均纳入了横断面队列，20 名患者纳入了前瞻性队列。超过三分之一（34.2%）的患者是非二元性别。手术后，两个队列的心理社会和性健康、满意度、与身体意象相关的生活质量和性别一致性都有所提高（p < 0.001），且抑郁（p < 0.009 横断面）和焦虑（p < 0.001 横断面）有所降低。最常见的不良事件是肥厚性瘢痕，41 名（36.9%）患者发生了这种情况。
在这项针对跨性别男性和非二元性别成年人的研究中，性别肯定乳房切除术之后，心理社会功能有了显著的改善。
