Patients' priorities regarding Female-to-Male gender affirmation surgery of the genitalia - A pilot study of 47 patients in Sweden

No surgical technique is reported to be the best option for gender affirmation surgery of the genitalia (GAS) in trans-men. Despite the fact that the patients’ preferences are central when choosing surgical technique, no... [ view full abstract ]

No surgical technique is reported to be the best option for gender affirmation surgery of the genitalia (GAS) in trans-men. Despite the fact that the patients’ preferences are central when choosing surgical technique, no studies are reporting what patients prefer. We aim to investigate trans-men patients’ priorities and preferences regarding GAS of the genitalia.

To investigate patients’ priorities and preferences regarding GAS for transmen thereby enabling future research to be better aligned with patients' needs. [ view full abstract ]

To investigate patients’ priorities and preferences regarding GAS for transmen thereby enabling future research to be better aligned with patients' needs.

From November 2015 to March 2016, 54 trans-men patients with the diagnosis of gender dysphoria, who were referred to Sahlgrenska University Hospital for discussing therapeutic steps (surgery and hormonal treatments), were... [ view full abstract ]

From November 2015 to March 2016, 54 trans-men patients with the diagnosis of gender dysphoria, who were referred to Sahlgrenska University Hospital for discussing therapeutic steps (surgery and hormonal treatments), were asked to fill in a questionnaire regarding different attributes achievable with GAS, such as sexual and urinary function, appearance, etc. 47 (87%) patients answered the questionnaire. Age ranged between 18 and 52 years with a mean of 26 years (standard deviation 7.4). At the time of interview, no patient had undergone any GAS of the genitalia.

Out of the patients who reported on their gender identity, 76% identified themselves as male and 24% wrote other terms, such as “mostly male”, “intergender” and “non-binary”. [ view full abstract ]

Out of the patients who reported on their gender identity, 76% identified themselves as male and 24% wrote other terms, such as “mostly male”, “intergender” and “non-binary”.

Gender identity had significant impact on patients’ preferences in two questions: the importance of vaginal removal, and the importance of having a penis that would be passable in places such as male dressing rooms. Both... [ view full abstract ]

Gender identity had significant impact on patients’ preferences in two questions: the importance of vaginal removal, and the importance of having a penis that would be passable in places such as male dressing rooms. Both these items were more important to patients identifying themselves as male. The most important attributes requested were: preserved orgasm ability and tactile sensation. The least important attribute was the removal of the vagina, followed by having a penis by human material, minimal scarring, and size. The ability to urinate while standing was considered of highly priority by some, and least priority by others.

 All answers ranged from being scored as “unimportant” to “imperative”. 

Our series of patients presents a considerable heterogeneity among trans-men patients in both gender identity and preferences regarding GAS, which supports the need of several techniques. The patients must be accurately... [ view full abstract ]

Our series of patients presents a considerable heterogeneity among trans-men patients in both gender identity and preferences regarding GAS, which supports the need of several techniques. The patients must be accurately informed regarding the different techniques and their specific benefits and limitations in order to make an informed choice.