PURPOSE: Masculinizing chest reconstruction in the transmale and gender non-binary patient populations is integral in treatment of gender dysphoria. The present study sought to evaluate the effect of gender identity on clinical and patient reported post-operative outcomes (PROs) following chest masculinization surgery.
METHODS: Patients who underwent double-incision subcutaneous gender-affirming mastectomies within one institution (2014-2019) were queried, demographics, surgical and post-operative variables were collected and PROs were obtained using a validated metric (BODY-Q scales, Q-portfolio). Patients were stratified according to gender identity: Transgender Male (n=130), Non-Binary (n=13), and Other (n=10). Univariate analysis was performed.
RESULTS: Of the 153 complete responders, 85% identified as transgender male, 8.5% as non-binary, and 6.5% as another gender identity. Patients identifying as non-binary or another gender identity were significantly less likely to be on pre-operative hormone therapy (p=<0.001). Otherwise, demographic and pre-operative variables were similar across the groups. No statistical difference was found in post-operative complications. Overall satisfaction was similar across groups but there was a trend towards lower nipple satisfaction in non-binary individuals.
CONCLUSION: Gender identity is a non-modifiable risk factor, but remains an unknown variable for clinical and PROs following chest masculinization. We found no significant difference in post-operative complications between transmen, non-binary individuals, or other gender-identifying individuals and high post-operative satisfaction was seen in all groups.