Table 2.
Summary of findings.
| Outcome | Number of studies (n)1 | Summary of findings1 | Strength of Evidence |
|---|---|---|---|
| Surgical satisfaction |
|
Direct evidence with medium study limitations suggests that most transgender men and women report satisfaction with their chest and genital surgeries. Similar outcomes were reported in transgender women who underwent facial, vocal cord, and Adam’s apple removal surgeries. | High |
| Surgical regret |
|
Direct evidence with medium study limitations suggests that the vast majority of transgender women and men do not regret undergoing chest/genital surgery. | Medium |
| Psychological and social functioning |
|
Direct evidence with high study limitations suggests that transgender men who underwent chest surgery reported moderately high levels of psychological and social functioning comparable to transgender men who did not undergo chest surgery | Low |
| Psychosocial wellbeing |
|
Direct evidence with high study limitations suggests transgender women overall reported improvements in their psychosocial wellbeing from pre- to post-surgery | Low |
| Sexual wellbeing |
|
Direct evidence with medium study limitations suggests that most transgender women report positive sexual wellbeing outcomes following chest and genital surgeries. Similar inferences also apply to transgender men who underwent genital surgery | High |
| Self-esteem |
|
Direct evidence with medium study limitations suggests transgender men who undergo genital surgery report high and/or improved self-esteem levels. | Medium |
| Life satisfaction |
|
Direct evidence with medium study limitations suggests that most transgender men and women do not report having poor life satisfaction following genital surgery. Similar inferences also apply to transgender women who underwent facial and/or voice surgeries | Medium |
| Depression and anxiety |
|
Direct evidence with medium study limitations suggests transgender men who underwent genital surgery do not report having high levels of depression and anxiety. Additionally, these levels were comparable with normative data (e.g., the German general population). Further, transgender women who underwent genital surgery report low levels of depression |
Medium |
| Happiness |
|
Direct evidence with medium study limitations suggests transgender men women report having positive happiness levels following genital surgery. Similar results were observed in transgender women who underwent facial surgery. | Medium |
| Gender dysphoria | One retrospective quantitative study on transgender women who underwent genital surgery (66) | Direct evidence with high study limitations suggests that most transgender women who undergo chest surgery reported that their gender dysphoria was resolved. | Low |
| Gender incongruence and misgendering | One retrospective quantitative study on transgender women who underwent facial surgery (220) | Direct evidence with medium study limitations suggests that most transgender women who undergo facial surgery report feeling less incongruent with their gender identity, as well as fewer instances of misgendering. | Medium |
| Emotional stability | One retrospective quantitative study on transgender men who underwent genital surgery (32) | Direct evidence with high study limitations suggests transgender men who undergo genital surgery have a “well-balanced” emotional stability comparable to that of the German general population. | Low |
| Health-related quality of life | Three retrospective quantitative studies on transgender women who underwent facial surgery (157) | Direct evidence with medium study limitations suggests that transgender women who undergo facial surgery report positive and/or improved health-related quality of life outcomes | Medium |
| Voice-related quality of life | Two prospective quantitative studies on transgender women who underwent vocal cord surgery (58) | Direct evidence with medium study limitations suggests that transgender women reported that their voice-related quality life improving after undergoing voice surgery | Medium |
1. Due to the similarity of study designs and findings across all studies reviewed, the summary of findings combines findings from both transgender men and women.