(145) Utilization of Crowdfunding for Genital Gender Affirmation Surgery

Abstract

Abstract Introduction Though the incidence of gender-affirming surgery (GAS) is increasing within the United States (US), many transgender and gender diverse individuals are denied insurance coverage for these procedures. Some turn to crowdfunding for financial assistance. Objective We aimed to determine characteristics of fundraisers for genital GAS within the US and factors associated with greater funding. Methods GoFundMe is the largest individual crowdfunding platform in the US and was queried in January 2023 using search terms related to genital GAS such as “bottom surgery”, “gender affirming surgery”, and “transgender surgery”. Duplicate, outside the US, non-English, and non-relevant campaigns were excluded. For each campaign, organizer’s state, fundraising goal, amount raised, number of donors, and campaign description were retrieved. Generalized additive models were created to determine the relationship of predictors with achieving full funding. An additional Bayesian estimation approach model was created to determine the relationship of predictors with overall campaign progress. Results From 4,921 viewable campaigns, 1,497 met inclusion criteria for analysis. All states were represented with the greatest number in California (n = 155, 10.4%). The median amount raised was $195 (IQR 0-2,270) of a goal of $12,000 (IQR 5,000-30,000); 87 (5.8%) campaigns were fully funded, while 555 (37.1%) had no funding. Three-quarters of campaigns were less than one-third funded. Of 1,315 campaigns where transition type was indicated, 76.6% (n = 1,007) were for FGS and 22.7% (n=298) were for MGS. Though the average marginal effect of increasing the goal was to decrease funding progress (FGS -0.329, 95% CI -0.445 to -0.0248, MGS -0.589, 95% CI -1.071 to -0.347), an increase in funding progress was seen with increasing the goal from $1,000 to $10,000 for FGS. The average marginal effect of increasing word count was +0.26 (95% CI 0.18 to 0.36) with the greatest effect between 100 to 500 words. The average marginal effect of increasing campaign age on progress was +0.35 (95% CI 0.27 to 0.47), with the greatest effect between 500 to 1000 days. Conclusions Crowdfunding is an attractive option for TGD individuals who need financial support for genital GAS and related expenses, but the majority of individual fundraisers on GoFundMe will only raise one-third or less of their goal. Specific windows of funding goal, word count, and campaign age are associated with greater odds of campaign progress. Such information can be used to counsel patients who are seeking financial assistance for genital GAS. Disclosure No.