Psychosocial Benefits of Mastectomy and Chest Wall Reconstruction Among Transgender Patients
Alexandra Bucknor, Maria Semnack, Sherise Epstein, Renata Flecha-Hirsch, Parisa Kamali, Winona Wu, Samuel Lin, Adam Tobias
Beth Israel Deaconess Medical Center, Boston, MA, USA
Background This study aims to analyze patient-reported outcomes after mastectomy and chest wall reconstruction in transgender patients. Method We generated a 15-item questionnaire. Data were retrieved for patient gender identity, age, and time since index surgery. Respondents were asked to consider how much they agreed with statements on chest appearance and psychosocial outcomes compared with before they had surgery, using a 5-part Likert scale ranging from ‘strongly agree' to ‘strongly disagree'. Results We received 50 responses (75.7% response rate). Mean age of respondents was 28.4 years (standard deviation, SD, 8.4 years) and mean time since surgery was 9.4 months (SD 5.6 months). Most respondents identified as ‘male' or ‘man' (58%, n=29), compared to transgender identities such as ‘transgender', ‘transmale', ‘transmasculine', and ‘non-binary', among others (42%, n=21). Most respondents ‘strongly agreed' that they were satisfied with overall appearance (92%), chest contour (90%), nipple-areola complex (84%), and their scars (60%). Regarding psychosocial outcomes, most ‘strongly agreed' that compared with before surgery, they were more confident without clothes (82%), had better mental health (68%), felt more confident in their gender identity (82%), and felt safer in public spaces (66%). Moreover, 96% had no regrets about surgery. Conclusion In this large, single-center cohort, results strongly suggest that there are psychosocial benefits to mastectomy and chest wall reconstruction in the transgender population.
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