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Nonbinary Patient Goals in Gender Affirming Surgery
Luci Hulsman, BS; Natalie Scanlon, BS; Julia A. Cook Beresford, MD; Sidhbh Gallagher, MD
Indiana University School of Medicine
2023-01-31
Presenter: Luci Hulsman
Affidavit:
Luci Hulsman developed the bulk of the study and design, creating and submitting a proposal to the IRB, gathering data, analysis, and writing the manuscript. Julia Cook Beresford and Sidhbh Gallagher served as reviewers of the survey, data analysis, and abstract/manuscript of the project. This material has not been published or previously presented.
Director Name: Sidhbh Gallagher
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Aesthetics
Introduction: Gender affirming surgery is a cornerstone to many transgender individuals' physical transition. Currently available literature focuses on the surgical goals of binary transgender patients, but there is a paucity of research dedicated to nonbinary patients. The aim of this study is to evaluate physical and healthcare preferences of nonbinary gender participants.
Methods: Participants were recruited through social media. All participants were 18 years or older and identified as nonbinary. Data points of interest included details of previous and planned gender affirming surgeries, hormone therapy goals, and general healthcare experiences. For participants with previous or planned top surgery, data was collected on chest fullness, nipple size and nipple placement.
Results: Of 522 participants, 504 identified as nonbinary assigned female at birth (AFAB, 96.6%). There were 435 AFAB participants (86.3%) with plans of top surgery. Surgical goals varied in the desire for nipples (54.4% desire nipples, 21.4% no nipples), nipple size (74.6% smaller, 5.4% larger), nipple location (79.7% lateral, 5.4% central), and chest fullness (78.1% flat, 17.7% minimal). Among AFAB participants without surgical history, 38.8% desired hormone therapy, of which 53.3% desired a dosage that was lower than a standard binary dosage. Of all participants, 25.6% strongly agreed to increased difficulty accessing healthcare.
Conclusion: Nonbinary participants had greater variation in top surgery preferences and hormone therapy goals compared to previously studied binary transgender patient preferences. This study encourages providers to discuss specific goals in gender care rather than assuming a "one-size fits all" approach to gender affirming treatment.
