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. 2023 Mar 1;277(3):e725-e729.
doi: 10.1097/SLA.0000000000005158. Epub 2021 Aug 13.

Gender Affirming Mastectomy Improves Quality of Life in Transmasculine Patients: A Single-center Prospective Study

Megan Lane  1 , Michael J Kirsch  2 , Emily C Sluiter  3 , Shelby R Svientek  1 , Jennifer B Hamill  1 , Shane D Morrison  1 , Graham C Ives  4 , Emma Alman  1 , Robert H Gilman  1 , William M Kuzon  1 , Paul S Cederna  1 , Edwin G Wilkins  1
Affiliations

Gender Affirming Mastectomy Improves Quality of Life in Transmasculine Patients: A Single-center Prospective Study

Megan Lane et al. Ann Surg. .

Abstract

Objective: To determine the impact of gender-affirming mastectomy on depression, anxiety, and body image.

Background: There are many cross-sectional and ad-hoc studies demonstrating the benefits of gender-affirming surgery. There are few prospective investigations of patient-reported outcomes in gender-affirming surgery using validated instruments.

Methods: In this prospective study, patients presenting to the University of Michigan for gender-affirming Mastectomy were surveyed preoperatively and 6-months postoperatively. Primary outcomes were patient-reported measurements of anxiety measured by General Anxiety Disorder-7, depression measured by Patient Health Questionnaire-9, body image measured by BODY-Q and Body Image Quality of Life Index, psychosocial and sexual functioning measured by BREAST-Q, and satisfaction with decision measured by BREAST-Q. Linear regression analysis was used to control for presence of complication and existing history of mental health conditions.

Results: A total of 70 patients completed the study. The average age of participants was 26.7. The mean Patient Health Questionnaire-9 score pre-operatively was 7.8 and postoperatively was 5.4 ( P =0.001). The mean preoperative and postoperative General Anxiety Disorder-7 scores were 7.6 and 4.6, respectively ( P <0.001). There were significant improvements in both psychosocial (35 to 79.2, P <0.001) and sexual (33.9 to 67.2, P< 0.001) functioning related to chest appearance as measured by the BREAST-Q and global psychosocial functioning (-15.6 to +32, P <0.001) as measured by the Body Image Quality of Life Index. Satisfaction with chest contour (14.3 to 93.8, P <0.001) and nipple appearance (29.3 to 85.9, P <0.001) measured by the BODY-Q significantly improved. Patients had a mean satisfaction with outcome score of 93.1.

Conclusions: Patients undergoing gender-affirming mastectomy in this single-center prospective study reported significant improvements in anxiety, depression, body image, psychosocial, and sexual functioning after this procedure. Patients were extremely satisfied with the decision to undergo this operation.

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Conflict of interest statement

The authors report no conflicts of interest.

References

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    1. Turban J. What is Gender Dysphoria?. American Psychiatric Association. https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-ge... . Published November 2020. Accessed March 1, 2021.
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    1. Aldridge Z, Patel S, Guo B, et al. Long-term effect of gender-affirming hormone treatment on depression and anxiety symptoms in transgender people: A prospective cohort study. Andrology. 2021;9:1808–1816.
    1. Lane M, Kirsch MJ, Sluiter EC, et al. Prevalence of psychosocial distress in transmen seeking gender-affirming mastectomy. Plast Reconstr Surg. 2020;146:1376–1380.

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