Impact of the preoperative hormone therapy duration on the satisfaction of transgender men after chest masculinization surgery

Abstract

Introduction Chest masculinization is currently the most commonly performed gender-affirming surgery. It is often preceded by testosterone replacement therapy, whose duration is not agreed upon before surgery. Our study evaluates the postoperative satisfaction of transgender men who have undergone chest masculinization surgery according to their preoperative hormonal treatment duration. Material and methods We conducted a single-center prospective study conducted from 2021 to 2022. All transgender men older than 18 years who had chest masculinization surgery were included. Demographic data, medical history, operative data, and duration of preoperative hormone therapy were collected. Participants completed the BREAST-Q© and BODY-Q© questionnaires pre- and postoperatively. Results Forty-six patients were included, with a median age of 21 years (18–45 years). The median preoperative testosterone duration was 596 days (186–4479 days). A significant improvement was found in BREAST-Q© (psychosocial, sexual and physical well-being; satisfaction with chest) and BODY-Q© (satisfaction with chest and nipples) parameters (p < 0.01). There was no significant correlation between preoperative hormone therapy time and chest satisfaction of BREAST-Q© (ρ = 0.069; R2 = 0.002; p = 0.647) and BODY-Q© (ρ = –0.114; R2 = 0.007; p = 0.450). Conclusion All patients in our study were exposed to exogenous testosterone for at least six months. Our study suggests that satisfaction remains unchanged with a longer duration of usage, indicating that an extended period of hormone impregnation may not be necessary before performing chest masculinization surgery in transgender men. Furthermore, the findings confirm a significantly high post-operative satisfaction rate among participants, emphasizing the positive impact of this type of surgery.