Table 3.

Associations of gender confirmation, gender identity, and procedures aimed at changing secondary sex characteristics with low transgender congruence and body image scores

Variables of interest	Total N	N (%) within treatment category	Unweighted analyses			Weighted analyses
			PRa	95% CIb		PRa	95% CIb
Transgender congruence score below medianc
Gender confirmation category
Definitive bottom surgery	149	33 (22%)	1.00	(reference)		1.00	(reference)
Partial bottom surgery	77	34 (44%)	2.11	1.38	3.23	2.15	1.37	3.37
Top surgery	161	71 (44%)	2.06	1.39	3.05	2.10	1.39	3.17
HT only	210	138 (66%)	3.03	2.14	4.30	3.22	2.25	4.61
No treatment	27	23 (85%)	3.96	2.72	5.75	3.66	2.28	5.88
Gender identity
Transfeminine	306	150 (49%)	1.00	(reference)		1.00	(reference)
Transmasculine	318	149 (47%)	0.95	0.77	1.15	1.03	0.83	1.28
Changes in secondary sex characteristics
Yes	75	30 (40%)	1.00	(reference)		1.00	(reference)
No	549	269 (49%)	0.88	0.68	1.12	0.87	0.68	1.13
Body image score below mediand
Gender confirmation category
Definitive bottom surgery	150	49 (33%)	1.00	(reference)		1.00	(reference)
Partial bottom surgery	79	39 (49%)	1.42	1.01	2.01	1.58	1.10	2.26
Top surgery	167	67 (40%)	1.19	0.85	1.65	1.25	0.88	1.78
HT only	220	116 (53%)	1.59	1.20	2.10	1.72	1.27	2.32
No treatment	28	17 (61%)	1.81	1.22	2.68	1.75	1.08	2.83
Gender identity
Transfeminine	319	139 (44%)	1.00	(reference)			(reference)
Transmasculine	325	149 (46%)	1.09	0.88	1.36	1.11	0.88	1.39
Procedures to change secondary sex characteristics
Yes	77	24 (31%)	1.00	(reference)			(reference)
No	567	264 (47%)	1.24	0.87	1.76	1.29	0.87	1.90

^aPR, prevalence ratio adjusted for age, race, study site, and all variables listed in the table.

^bCI, confidence interval

^cModel based on 624 observations

^dModel based on 644 observations