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Community Perspectives In The Risk Acceptance Of Transmasculine Gender Affirming Genital Surgery
Ermina Lee, BS, Jules Madzia, PhD, Harini Pallerla, MS, Ryan Gobble, MD, Sarah Pickle, MD.
University of Cincinnati College of Medicine
2024-01-31
Presenter: Ermina Lee
Affidavit:
Dr. Ann R. Schwentker
Director Name: Dr. Ann R. Schwentker
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Purpose:
To describe the surgical goals and risk acceptance of transgender individuals who are interested in future procedures including metoidioplasty, phalloplasty, and penile prosthesis.
Methods:
A cross-sectional survey was constructed from scoping literature review and community input. Survey distribution occurred over 6 months via national listservs with 74 respondents. Statistical analyses were performed in SPSS 28.
Results:
50.0% of respondents identified as trans men, 36.5% as men, and 13.5% as nonbinary or genderqueer. 53.8% were age 25-34 and the majority identified as White. 94.5% of respondents were aware of risks related to phalloplasty. Respondents demonstrated high awareness of risks related to urethral lengthening (90.4%), metoidioplasty (71.2%), and penile prosthesis (63.0%). For metoidioplasty and phalloplasty, respondents were most aware of issues with urination (93.2%). For penile prosthesis, respondents were most aware of the risk of removal (77.1%) and issues with penetrative sex (71.4%). 31.9% of respondents did not know how long a penile prosthesis would last, and 20.8% anticipated one would last more than 7 years. 21.6% of respondents indicated that internal canal/vagina preservation was very/extremely important. Penetrative sex and standing to pee were very/extremely important to 75.3% and 64.4% of respondents.
Conclusion:
Our results suggest that while prospective patients have access to knowledge on phalloplasty, more resources are necessary to address knowledge gaps in metoidioplasty and penile prosthesis. Penetrative sex, standing to pee, and internal canal/vagina preservation are not equally important among transgender individuals. Surgical centers should individualize care to each patient's unique experience of gender incongruence.
