Abstract
Objectives An increasing number of mastectomies and hysterectomies are performed for transgender men each year, howeverthere is a paucity of evidence supporting transgender individuals undergoing gender affirmation surgery. The objective of this study was to determine rates of surgical complications in transgender men undergoing mastectomy and hysterectomy. Methods A descriptive study using the American College of Surgeons' National Surgical Quality Improvement Program (2015–2016) was conducted. Transgender patients were identified using the International Classification of Diseases diagnostic codes (Z87.89, F64). Surgical cases of mastectomy and hysterectomy were identified using Current Procedural Terminology codes. Results We identified 104 cases of mastectomy and 252 cases of hysterectomy for transgender men. Transgender men appear to be young when seeking mastectomy (29.44±8.39 years) and hysterectomy (29.51±9.24 years). The majority of mastectomies (92.3%) and hysterectomies (90.1%) were performed in the outpatient setting. We found 93.3% of hysterectomies were performed laparoscopically. Surgical site infection was the most common complication for both mastectomy (1.9%) and hysterectomy (1.6%). Overall, transgender men demonstrated low operative complications, including but not limited to: UTI (0.0%,0.4%), sepsis (0.0%,0.4%), wound dehiscence (0.0%,0.0%), deep vein thromboembolism (0.0%,0.0%), pulmonary embolism (0.0%,0.0%), re-operation (0.0%,0.0%) and 30-day mortality (0.0%,0.0%) for mastectomy and hysterectomy, respectively. Conclusions Transgender men undergoing gender affirmation surgery do not appear at elevated risk of surgical complications. Our findings support transgender men as suitable candidates for mastectomy and hysterectomy with appropriate surgical outcomes. We believe these findings will garner interest among researchers supporting the transgender community and provide evidence for reducing barriers to accessing care for this understudied population.
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