Sun Helen H, Gillani Braveheart, Rhodes Stephen, Hamilton Daniel, Gupta Shubham, Banik Swagata, Feerasta Gulnar, Pope Rachel
Urology Institute, University Hospitals Cleveland Health System, Cleveland, OH, USA.
Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Int J Impot Res. 2024 Oct 15. doi: 10.1038/s41443-024-00991-7.
Gender-affirming surgery (GAS) is a highly personalized decision for transgender and gender diverse (TGD) individuals. However, the proportion of TGD individuals who desire GAS is unknown. A questionnaire was created after identifying themes surrounding experiences with gender-affirming medical care by community focus groups. Respondents who reported medically transitioning and who had undergone GAS were compared to those without prior GAS. From 88 completed surveys, 18 (20.5%) individuals did not wish to undergo GAS. Of those medically transitioning and desiring GAS, 15.2% (9/59) desired GAS but had not received it yet, with 6.7% (6/9) identifying as non-binary. Individuals who had not had GAS were more likely to earn under $15,000 annually, compared to $25,000-49,000 in the GAS group (p = 0.01). There was no significant difference in educational level (p = 0.32) or insurance status (p = 0.33). Of TGD individuals who desire GAS, out-of-pocket expenses such as hair removal, opaque insurance policies, lack of social support, and access to gender-affirming providers can hinder the transition process. Understanding barriers and rationales for pursuing GAS can provide targets for improving healthcare delivery to this diverse population.
性别肯定手术（GAS）对于跨性别和性别多样化（TGD）个体来说是一个高度个性化的决定。然而，渴望接受性别肯定手术的TGD个体的比例尚不清楚。在通过社区焦点小组确定围绕性别肯定医疗护理经历的主题后，创建了一份调查问卷。将报告进行了医学过渡并接受了性别肯定手术的受访者与未接受过该手术的受访者进行了比较。在88份完成的调查中，18名（20.5%）个体不希望接受性别肯定手术。在那些进行了医学过渡并渴望接受性别肯定手术的个体中，15.2%（9/59）渴望接受手术但尚未接受，其中6.7%（6/9）为非二元性别。与接受性别肯定手术组的25000 - 49000美元相比，未接受该手术的个体年收入更有可能低于15000美元（p = 0.01）。教育水平（p = 0.32）或保险状况（p = 0.33）没有显著差异。在渴望接受性别肯定手术的TGD个体中，诸如脱毛等自付费用、不透明的保险政策、缺乏社会支持以及能否获得性别肯定医疗服务提供者等因素可能会阻碍过渡过程。了解追求性别肯定手术的障碍和基本原理可以为改善向这一多样化人群提供医疗服务提供目标。
