Abstract
ObjectiveTo describe choices of transgender and gender diverse (TGD) late adolescents assigned female at birth regarding gender-affirming surgery (GAS). MethodsParticipants aged 18-21 completed an online survey that included demographic characteristics, surgical history, desire for GAS, and barriers to care. ResultsTwo hundred and sixty surveys were completed. Forty-three (16.7%) respondents had undergone GAS. Of those who had not, 178 (83%) planned to do so in the future, and 15 (7%) reported no desire to undergo GAS. One hundred and sixteen (54%) had not due to financial reasons, 54 (25%) due to insurance difficulties, and 28 (13%) because they were unable to find a surgeon. ConclusionTGD late adolescents assigned female at birth have varying desires for future GAS that align with their gender expression. They also face many barriers to care. It is important for health care providers to be aware of the unique desires of TGD adolescents, not assume any particular surgical path for gender affirmation, and acknowledge the barriers experienced.
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