Gender Affirmation Surgery-related Hashtag Utilization on Instagram: Implications for Education and Patient Care

Abstract

Background: Gender-affirmation surgery (GAS) allows for transgender and nonconforming patients to achieve a more congruent physical appearance and alleviate dysphoria. Social media, such as Instagram, has adopted an increasingly important role in plastic and reconstructive surgery, and understanding trends and usage related to GAS can have significant implications for patient education and outreach. As such, this cross-sectional study aims to address the following questions related to GAS-related content available on Instagram: (1) Who is posting this content? (2) What specific hashtags are they using? and (3) What are the implications behind these posts?

Methods: This study analyzed 22 GAS-related hashtags on Instagram. Content analysis was then used to evaluate the "top" 15 posts (n = 330) associated with each hashtag.

Results: A total of 425,607 posts were associated with the 22 hashtags queried. #topsurgery had the highest number of associated posts (n = 279,480), followed by #ftmtopsurgery (n = 41,769) and #vaginoplasty (n = 39,737). Of the "top" 330 posts, 299 were not duplicates. Plastic surgeons eligible for membership in the American Society of Plastic Surgeons accounted for only 1.7% of "top" posts (n = 5); noneligible physicians accounted for 6.0% of posts (n = 18). Patients accounted for the majority of the "top" posts sampled (n = 236; 79.9%).

Conclusions: When used appropriately, social media can be a powerful tool for spreading awareness on procedures and educating patients. Although there is a paucity of plastic surgeons posting GAS-related content on Instagram, patients are playing an important role in disseminating information.

Fig. 1.

A flowchart that outlines this study’s inclusion and exclusion of hashtags and posts.

Fig. 2.

Number of “top” posts came from patients/bloggers, clinics, foreign surgeons, obstetrician and gynecologist, ASPS eligible plastic surgeons, non-ASPS eligible plastic surgeons, or other. Plastic surgeons, and specifically ASPS eligible surgeons, are underrepresented amongst those posting GAS-related content to Instagram.

Fig. 3.

Top posts and hashtag utilization. Specifically, it shows how many posts used more than one of the 22 hashtags analyzed (eg, 44 posts used two hashtags, 16 posts used three, and so on).