Surgical Gender Affirmation

Surgical Gender Affirmation

Ruben Hopwood, MDiv, PhD Coordinator, Transgender Health Program, Fenway Health

Timothy Cavanaugh, MD Medical Director, Transgender Health Program, Fenway Health

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Continuing Medical Education Disclosure

Program Faculty: Tim Cavanaugh, MD Current Position: Medical Director, Transgender Health Program, Fenway Health Disclosure: No relevant financial relationships. All hormone therapy for transgender

people is off-label. Program Faculty: Ruben Hopwood, PhD Current Position: Coordinator, Transgender Health Program, Fenway Health, and

Psychology Fellow, Boston University, The Danielsen Institute Disclosure: No relevant financial relationships. All hormone therapy for transgender people is off-label.

It is the policy of The National LGBT Health Education Center, Fenway Health that all CME planning committee/faculty/authors/editors/staff disclose relationships with commercial entities upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest and, if identified, they are resolved prior to confirmation of participation. Only participants who have no conflict of interest or who agree to an identified resolution process prior to their participation were involved in this CME activity.

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Learning Objectives

1. Participants will be able to identify and broadly define surgical options available both to trans men and trans women.

2. Participants will be able to identify potential surgical complications for major gender affirming surgeries

3. Participants will be able to discuss consequences of or alternatives when surgery is not available or desired

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Surgery: Gender Affirmation (GAS); Sex Reassignment (SRS); Genital Reconstruction (GRS)

Surgery has proven to be an effective intervention for the patient with gender dysphoria.

Patient satisfaction following surgery is high,

And reduction of gender dysphoria following surgery has psychological and social benefits.

As with any surgery, the quality of care provided before, during, and after surgery has a significant impact on patient outcomes.

Not for everyone!

Is someone ready?

Insurance coverage historically has been difficult to obtain.

Lawrence, A. A. (2003). Factors Associated With Satisfaction

or Regret Following Male-to-Female Sex Reassignment

Surgery. Archives of Sexual Behavior, 32(4), 299?315.

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Utilization of Surgery

MtF Chest Surgery

Want Someday

54%

Don't Want 28%

Have Had 18%

Grant, J. M., Mottet, L. A., Tanis, J., Harrison, J., Herman, J. L., &

Keisling, M. (2011). Injustice at every turn: A report of the National

Transgender Discrimination Survey. Washington, DC: National

Center for Transgender Equality and National Gay and Lesbian

Task Force.

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Utilization of Surgery

FtM Chest Surgery

Don't Want 8%

Want Someday

51%

Have Had 41%

FtM Metoidioplasty

Want Someday

52%

Have Had 3%

Don't Want 45%

FtM Hysterectomy

Want Someday

57%

Don't Want 23%

Have Had 20%

FtM Phalloplasty

Have Had 2%

Want Someday

26%

Don't Want 72%

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Language

Non-judgmental

The majority of transgender people who have had surgical or medical alterations of their bodies are very satisfied with the results

Devaluing

Sadly, health care providers often use disparaging language or tones of voice when talking to clients about the clients' surgical or medical body alterations or desires for body alterations

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Psychotherapy is not an absolute requirement for hormone therapy and surgery

WPATH, SOC, v.7, 2011

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