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. 2022 Jun 13;14(6):e25906.
doi: 10.7759/cureus.25906. eCollection 2022 Jun.

National Trends in Gender-Affirming Surgical Procedures: A Google Trends Analysis

Emily Merrick  1 , Joshua P Weissman  1 , Mona Ascha  1 , Sumanas W Jordan  1 , Marco Ellis  1
Affiliations

National Trends in Gender-Affirming Surgical Procedures: A Google Trends Analysis

Emily Merrick et al. Cureus. .

Abstract

Background: There has been a significant increase in the volume of gender-affirming surgical (GAS) procedures over the past decade. The objective of this paper is to use online search data from Google Trends (GT) to describe national search trends for GAS procedures.

Methods: GT was queried for search terms relating to GAS from January 2004 to February 2021. The 19 selected keywords covered a broad range of GAS topics. United States (US) search interest was collected as relative search volumes (RSVs) and then analyzed by geographic region. The number of plastic surgery providers offering GAS and academic surgery centers was collected from the World Professional Association for Transgender Health (WPATH) and Trans-health.com. RSVs were analyzed by metro area to determine the relationship between search demand and personal income. State Medicaid policies for transgender health services were also collected.

Results: All search terms demonstrated a positive increase in RSVs over time except "sex reassignment surgery" and "penectomy". The Mountain/Pacific and East South Central/West South Central had the greatest search volume for GAS and most providers offering care. The East South Central/West South Central region​​ ranked last for providers offering care, despite the relatively high search interest. This region also had no states with explicit Medicaid policies covering gender-affirming care. Metro areas in the top five for RSV but bottom quartile for per capita personal income were identified.

Conclusions: Online search interest for GAS-related terms has increased. Search interest for GAS has regional variation and did not show a specific pattern with provider availability.

Keywords: gender affirming surgery; google trends; non-binary; top surgery; transgender.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Regions defined according to the America Society of Plastic Surgeons, 2019 Plastic Surgery Statistics Report
Figure 2
Figure 2. Gender-affirming surgical (GAS) related search term interest by region
For all 19 search terms, the states with the top ten relative search volumes were listed. The number of times each state was included in the top 10 was noted and added into one of the five regions described by the America Society of Plastic Surgeons.
Figure 3
Figure 3. Plastic surgeon providers offering gender affirming surgeries
Plastic surgeon providers across the United States as listed on the World Professional Association for Transgender Health (WPATH) website.
Figure 4
Figure 4. Academic medical centers in the United States with dedicated transgender and non-binary care
States with academic medical centers with a dedicated transgender and non-binary surgery program or faculty dedicated to providing this type of care - World Professional Association for Transgender Health (WPATH) website.
Figure 5
Figure 5. Distribution of Medicaid policies regarding coverage of transgender and non-binary care across the United States
See this image and copyright information in PMC

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