009 There’s More to Surgery than a Steady Hand: Patient Reported Outcomes in Gender Affirming Surgery

Abstract

Many transgender individuals find that gender-affirming surgery is integral to feeling comfortable with their body. However, gender-affirming surgeries can be difficult to access, expensive, and fraught with high surgical complication rates. Moreover, surgeons may not be aware of the full nature and range of complications that occur as many patients travel for surgery and subsequently seek care for their complications in their hometown. To examine transgender patients’ self-report of complications and identify non-surgical factors (e.g. travel time to surgical appointments, thoroughness of consent process, comfort with surgeon and team, quality of discharge instructions, social supports) that are associated with increased self-reporting of complications. A retrospective survey of experiences with gender-affirming surgery was conducted in partnership with the provincial trans health program. A questionnaire with strong face validity was developed, with input from a peer reference group, and administered online after obtaining institutional research ethics approval. Instructions detailing the study and access to the survey were publicized through advertisements, social media, community organizations, and at public events within the transgender community. Data were collected from July 1st 2016 to June 30th, 2017. Participants were 18 years of age or older, and to be included in this analysis, had undergone gender-affirming surgery within the past 5 years. Participants provided data on their experience with accessing surgery, pre-operative appointments, and post-operative recovery. Participants were asked to describe any post-operative complications experienced either before or after discharge from hospital. Complications were then assigned a grade based on the Clavien-Dindo classification system and divided into grades 0-1 and ≥2. Data was then analyzed both for overall reporting of complications, and split by pre- and post-discharge, and by grade.