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Patient-reported Risk Awareness And Surgical Experience In 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 risk awareness and surgical experience of transgender individuals who underwent metoidioplasty, phalloplasty, or penile prosthesis.
METHODS:
Cross-sectional survey was created from a scoping literature review and community input. Survey distribution occurred over 6 months using national listservs with 53 respondents. Statistical analyses were performed in SPSS 28.
RESULTS:
53 respondents underwent metoidioplasty, phalloplasty, or penile prosthesis, of which 65.4% identified as trans men, 26.9% as men, 3.8% as nonbinary, and 3.8% as other. The majority were age 25-34 and identified as White. Respondents were highly aware of risks related to urethral lengthening (94.4%) and of risks related to phalloplasty (88.5%), penile prosthesis (83.3%), and metoidioplasty (68.8%). Potential morbidity related to the donor site (18.0%) and urinary tract (18.0%) changed respondent's surgical goals. For penile prothesis, 28.6% anticipated one would last more than 7 years. Both standing to pee and penetrative sex were very/extremely important to 71.2% of respondents. 79.6% and 70.6% of respondents felt that their genital appearance and genital function were very/extremely aligned with their gender identity. 92.3% were confident their surgical goals were achieved, and nearly all (98.2%) said bottom surgery positively impacted their life.
CONCLUSION:
Despite variance in self-reported alignment of genital appearance or function with gender identity, these findings suggest positive impact of gender-affirming genital surgery. Participants were knowledgeable on risks related to phalloplasty, urethral lengthening, and penile prosthesis, while information on metoidioplasty may be lacking. Future studies are necessary to develop PROMs that adequately capture quality of life outcomes.
