Gender-affirming care encompasses a range of medical, psychological, and social interventions designed to support and validate an individual’s gender identity. Within this spectrum of care, gender-affirming surgeries play a crucial role for many transgender and gender non-binary individuals. These procedures, which include facial feminization or masculinization surgery, “top surgery” (chest reconstruction or augmentation), and “bottom surgery” (genital procedures), are aimed at aligning physical characteristics with a person’s gender identity. It’s important to recognize that these surgical interventions are not exclusive to transgender individuals; they are established medical procedures that have been safely performed on cisgender and intersex individuals for various reconstructive and cosmetic purposes for many years.
Extensive research consistently demonstrates the safety and positive outcomes of gender-affirming surgeries. Studies comparing complication rates between transgender and cisgender individuals undergoing similar surgeries reveal comparable, and in some cases, even lower rates among transgender patients. Patient satisfaction rates following gender-affirming surgeries are overwhelmingly high across various procedures, including top surgery, bottom surgery, and facial surgery. These high satisfaction rates underscore the significant positive impact these procedures have on the lives and well-being of transgender individuals.
It is a common misconception that gender-affirming surgeries are frequently performed on minors. In reality, surgical interventions are generally not considered for transgender individuals under the age of 18. Exceptions are extremely rare and are reserved for specific circumstances where surgery is deemed medically necessary to alleviate severe gender dysphoria. Such cases involve rigorous evaluations and must adhere to strict protocols. These protocols include consistent and persistent expression of gender identity over several years, a period of gender-affirming hormone therapy, comprehensive informed consent discussions, and approvals from both parents or guardians and a multidisciplinary team of doctors. These stringent guidelines are in alignment with established standards of care criteria, such as those defined by the World Professional Association for Transgender Health (WPATH).
Data further illustrates the rarity of gender-affirming surgeries in minors. A comprehensive study analyzing a national pediatric surgical database in the U.S. over a four-year period (2018-2021) identified only 108 transgender minors who underwent any type of gender-affirming surgery. This minuscule number represents just 0.04% of the total transgender youth population nationwide. Notably, only a fraction of these minors were under 16 years old, and the vast majority of procedures performed (approximately 95%) were chest surgeries. Regardless of a patient’s age, the decision to proceed with gender-affirming surgery is always a carefully considered one, made after extensive consultations with mental health professionals, physicians, endocrinologists, and surgeons to ensure that surgery is the most appropriate and beneficial course of action for the individual.
