<< Back to the abstract archive
Nonbinary and Transgender Male Patient Preferences for Gender-Affirming Top Surgery
Rachel E. Schafer, BA, R'ay Fodor, BS, Raymond Isakov, MD, Cecile Ferrando, MD, Antonio Rampazzo, MD PhD, Bahar Bassiri Gharb, MD PhD
Cleveland Clinic Department of Plastic Surgery
2023-01-23
Presenter: Rachel E Schafer
Affidavit:
I agree with the stated break down of contributions below.
Director Name: Steven Bernard
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background: The most commonly performed gender-affirming surgery for transmen is chest masculinization. This study aimed to identify surgical goals and outcomes of patients identifying as non-binary versus transgender male.
Methods: Patients who underwent chest masculinization (2003-2022) were included. BODY-Q chest module was sent to patients who met inclusion criteria. Demographics, medical comorbidities, procedure types, intraoperative and postoperative complications, and survey responses were compared statistically.
Results: Three hundred and twelve patients met inclusion criteria. The survey response rate was 24% (76/312). Of the 76 respondents, twelve (16%) identified as nonbinary and 64 (84%) as trans-male. Age (23 yo vs 25 yo, p=0.3), BMI (28 vs 29, p=0.4), history of tobacco use (33% vs 33%, p>0.9), diabetes (0% vs 3.1%, p>0.9), hypertension (8.3% vs 4.7%, p=0.5), and depression (50% vs 42%, p=0.6) did not differ between cohorts. The most common procedure type was double incision with free nipple grafts for both groups (50% vs 74%, p=0.2, nonbinary and trans male, respectively). Nonbinary and trans male patients had equivalent rates of intraoperative (0% vs 1.6%, p>0.9) and postoperative complications (8.3% vs 11%, p>0.9). Both groups reported that surgery improved their overall quality of life (75% vs 84% strongly agree, p=0.5, nonbinary and trans male, respectively). Only 2 patients, both non-binary, didn't keep their nipple-areola complexes (NACs) and reported that no NACs were more congruent with their gender identity (p=0.023).
Conclusions: Non-binary patients have distinctive surgical preferences regarding NACs. Surgical planning might differ for this group of patients compared to their trans-male counterparts.
