Patient-reported satisfaction and health-related quality of life after chest masculinization in transgender men using the BODY-Q Chest module and the 15D instrument

Abstract

Chest masculinization is the most common surgical intervention in transgender men. Studies indicate good patient-reported postoperative satisfaction, but only recently was a patient-reported outcome instrument, BODY-Q Chest module, developed and validated for this patient group. This study aims to evaluate post-operative patient-reported satisfaction and health-related quality of life (HRQoL) using BODY-Q Chest module and the 15D after surgical chest masculinization in transgender men. The data comprised all patients receiving chest masculinization from 2005 to 2018. The patients were invited by letter to fill in the BODY-Q Chest module and the 15D questionnaire in May 2020. Of the 220 patients invited, 123 completed the survey, giving a response rate of 56%. The median chest and nipple scores were 76 and 68 out of 100, respectively. The number of secondary corrections had a negative association to the chest score (p-value<0.001). The 15D index score was lower compared to the age-standardized male population (p-value<0.001), but similar to the age-standardized female population. Psychiatric comorbidity was associated to lower 15D index scores (p-value<0.001). There was no statistically significant difference between the BODY-Q Chest module scores or the 15D index score between different surgical techniques. The postoperative satisfaction with chest masculinization is good and in line with previous literature. The HRQoL resembles that of the reference population. The periareolar technique is not associated with better satisfaction despite causing less scar burden. The negative association between the chest score and number of secondary corrections is unsettling and requires further examination in a prospective setting.