School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States.
Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States.
J Sex Med. 2024 Aug 1;21(8):729-733. doi: 10.1093/jsxmed/qdae077.
Previous studies present mixed evidence on the relationship between psychiatric comorbidities and genital gender-affirming surgery (GGAS) in individuals with gender incongruence (GI).
This research aims to investigate the psychiatric comorbidity rates post-GGAS in the GI population-namely, depressive disorders, anxiety disorders, posttraumatic stress disorders, substance abuse disorder, and suicidality.
Based on the TriNetX health care database, an international database with >250 million patients, a cross-sectional study was executed comparing psychiatric comorbidity rates among cases of GI with and without GGAS. Individuals were matched for demographic and health-related variables, which included history of cardiovascular disease, diabetes, and obesity.
The main focus was to establish the rates and changes in psychiatric comorbidities following GGAS.
Among individuals with GI, the study identified 4061 with GGAS and 100 097 without. At 1 year post-GGAS, there was a significant decrease in depression (odds ratio [OR], 0.748; 95% CI, 0.672-0.833; P < .0001), anxiety (OR, 0.730; 95% CI, 0.658-0.810; P < .0001), substance use disorder (OR, 0.730; 95% CI, 0.658-0.810; P < .0001), and suicidality (OR, 0.530; 95% CI, 0.425-0.661; P < .0001), and these reductions were maintained or improved on at 5 years, including posttraumatic stress disorder (OR, 0.831; 95% CI, 0.704-0.981; P = .028).
The findings indicate that GGAS may play a crucial role in diminishing psychiatric comorbidities among individuals with GI.
This is the largest known study to evaluate the effect of GGAS on psychiatric comorbidities in the GI population, offering robust evidence. The reliance on the precision of CPT and ICD-10 codes for data extraction poses a limitation due to potential coding inaccuracies.
The evidence suggests a significant association between GGAS and reduced psychiatric comorbidities in individuals with GI.
先前的研究对性别不一致（GI）个体的精神共病与生殖器性别肯定手术（GGAS）之间的关系提供了混合证据。
本研究旨在调查 GI 人群 GGAS 后的精神共病发生率，即抑郁障碍、焦虑障碍、创伤后应激障碍、物质使用障碍和自杀意念。
基于 TriNetX 医疗保健数据库，这是一个拥有超过 2.5 亿患者的国际数据库，进行了一项横断面研究，比较了有和没有 GGAS 的 GI 病例中的精神共病率。个体按人口统计学和健康相关变量进行匹配，这些变量包括心血管疾病、糖尿病和肥胖的病史。
主要重点是确定 GGAS 后精神共病的发生率和变化。
证据表明 GGAS 与 GI 个体的精神共病减少之间存在显著关联。
本研究依赖 CPT 和 ICD-10 代码的准确性来提取数据，这可能导致编码不准确，因此存在一定的局限性。
证据表明 GGAS 与 GI 个体的精神共病减少之间存在显著关联。
