Miller Amitai S, Lee Daniela, Fanning James E, Allen Avery E, Kaur Manraj N, Serwald Geraldine S, Fazzalari Amanda, Ranganathan Kavitha
Harvard Medical School, 25 Shattuck St., Boston, MA, 02115, USA.
Harvard University John F. Kennedy School of Government, Cambridge, MA, USA.
Aesthetic Plast Surg. 2025 Jun 24. doi: 10.1007/s00266-025-05017-1.
Many transgender and gender-diverse (TGD) individuals rely on online resources to obtain gender-affirming surgery (GAS) information. In 2021, US Centers for Medicare and Medicaid Services (CMS) mandated that hospitals disclose prices for common services and procedures. The aim of this study was to assess the online information and price availability for GAS in US-based hospitals.
The largest 100 hospitals by inpatient bed volume were included. Hospital websites were searched in October 2023 for terms pertaining to GAS, and price estimator tools were queried for 66 common CPT codes used in GAS. Data on hospital ownership, hospital income, Medicaid revenue, plastic surgery residency program presence, ZIP code median income, social vulnerability index score, and state-level nondiscrimination laws were also collected.
Out of 100 hospitals, 59 publicly offered GAS. Hospitals located in the US South and Church-owned hospitals were the least likely to have any GAS information availability (41.5% and 36.4%, respectively). Hospitals in states with laws protecting GAS insurance access and those with plastic surgery residency programs were more likely to publicly offer GAS. Only 48 hospitals offered any GAS pricing information. Of these hospitals, the median number of prices displayed was two, and only five hospitals disclosed prices for more than ten procedures. Pricing information was particularly limited for genital and facial procedures.
Significant gaps exist in the public availability of GAS information and price transparency, with notable regional and institutional disparities. Standardizing price estimator tools would enhance informed decision-making and reduce barriers to care. http://www.springer.com/00266 LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
许多跨性别和性别多样化（TGD）个体依靠在线资源获取性别肯定手术（GAS）信息。2021年，美国医疗保险和医疗补助服务中心（CMS）规定医院必须披露常见服务和程序的价格。本研究的目的是评估美国医院中GAS的在线信息和价格可获取性。
纳入了按住院床位数排名前100的医院。2023年10月搜索了医院网站中与GAS相关的术语，并查询了GAS中使用的66个常见CPT代码的价格估算工具。还收集了有关医院所有权、医院收入、医疗补助收入、整形外科住院医师培训项目情况、邮政编码中位数收入、社会脆弱性指数得分以及州级非歧视法律的数据。
在100家医院中，59家公开提供GAS。位于美国南部的医院和教会所有的医院提供任何GAS信息的可能性最小（分别为41.5%和36.4%）。有法律保护GAS保险获取权的州的医院以及设有整形外科住院医师培训项目的医院更有可能公开提供GAS。只有48家医院提供任何GAS定价信息。在这些医院中，显示的价格中位数为两个，只有五家医院披露了十多种手术的价格。生殖器和面部手术的定价信息尤其有限。
GAS信息的公开可获取性和价格透明度存在显著差距，存在明显的地区和机构差异。标准化价格估算工具将有助于做出明智的决策并减少医疗障碍。http://www.springer.com/00266 证据级别IV：本刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南www.springer.com/00266。
