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Barriers to Gender-affirming Surgery Consultations in a Sample of Transmasculine Patients in Boston, Mass.
Gender diverse people are increasingly pursuing gender-affirming surgery, but little is known about their experiences on accessing care. As part of the baseline assessment for an ongoing longitudinal study, we examined the types of barriers and self-reported out-of-pocket costs associated with gende...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7489736/ https://www.ncbi.nlm.nih.gov/pubmed/32983769 http://dx.doi.org/10.1097/GOX.0000000000003008 |
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author | Tabaac, Ariella R. Jolly, Divya Boskey, Elizabeth R. Ganor, Oren |
author_facet | Tabaac, Ariella R. Jolly, Divya Boskey, Elizabeth R. Ganor, Oren |
author_sort | Tabaac, Ariella R. |
collection | PubMed |
description | Gender diverse people are increasingly pursuing gender-affirming surgery, but little is known about their experiences on accessing care. As part of the baseline assessment for an ongoing longitudinal study, we examined the types of barriers and self-reported out-of-pocket costs associated with gender-affirming surgery most commonly endorsed by transmasculine chest (top) and genital (bottom) surgery patients at their initial surgical consultation. METHODS: A brief survey was administered to a clinical sample of transmasculine patients (n = 160; age ≥15 years) seeking a gender-affirming surgery at the Center for Gender Surgery in Boston, Mass. from April 2018 to February 2020. RESULTS: The barriers most commonly endorsed by top surgery patients were insurance coverage and age. For bottom surgery patients, the most commonly endorsed barriers were getting mental health letters and readiness for surgery. Bottom surgery patients were also more likely to report barriers of readiness for surgery and cost of/access to hair removal, than top surgery patients (Ps < 0.05). Bottom surgery patients were more likely to report out-of-pocket costs related to hair removal, surgical consultation, and surgery (Ps < 0.05), whereas top surgery patients were more likely to report hormone treatment costs (P = 0.01). Average out-of-pocket costs were high (mean = 2148.31) and significantly higher for bottom surgery patients (b = 4140.30; β = 0.64; 95% confidence interval, 3064.6–5216.0). CONCLUSIONS: Transmasculine patients experience a variety of barriers when seeking gender-affirming surgery. Presurgical requirements, insurance access, and high out-of-pocket costs may hinder access to care for many transmasculine people seeking bottom surgery. |
format | Online Article Text |
id | pubmed-7489736 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-74897362020-09-24 Barriers to Gender-affirming Surgery Consultations in a Sample of Transmasculine Patients in Boston, Mass. Tabaac, Ariella R. Jolly, Divya Boskey, Elizabeth R. Ganor, Oren Plast Reconstr Surg Glob Open Reconstructive Gender diverse people are increasingly pursuing gender-affirming surgery, but little is known about their experiences on accessing care. As part of the baseline assessment for an ongoing longitudinal study, we examined the types of barriers and self-reported out-of-pocket costs associated with gender-affirming surgery most commonly endorsed by transmasculine chest (top) and genital (bottom) surgery patients at their initial surgical consultation. METHODS: A brief survey was administered to a clinical sample of transmasculine patients (n = 160; age ≥15 years) seeking a gender-affirming surgery at the Center for Gender Surgery in Boston, Mass. from April 2018 to February 2020. RESULTS: The barriers most commonly endorsed by top surgery patients were insurance coverage and age. For bottom surgery patients, the most commonly endorsed barriers were getting mental health letters and readiness for surgery. Bottom surgery patients were also more likely to report barriers of readiness for surgery and cost of/access to hair removal, than top surgery patients (Ps < 0.05). Bottom surgery patients were more likely to report out-of-pocket costs related to hair removal, surgical consultation, and surgery (Ps < 0.05), whereas top surgery patients were more likely to report hormone treatment costs (P = 0.01). Average out-of-pocket costs were high (mean = 2148.31) and significantly higher for bottom surgery patients (b = 4140.30; β = 0.64; 95% confidence interval, 3064.6–5216.0). CONCLUSIONS: Transmasculine patients experience a variety of barriers when seeking gender-affirming surgery. Presurgical requirements, insurance access, and high out-of-pocket costs may hinder access to care for many transmasculine people seeking bottom surgery. Lippincott Williams & Wilkins 2020-08-19 /pmc/articles/PMC7489736/ /pubmed/32983769 http://dx.doi.org/10.1097/GOX.0000000000003008 Text en Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Reconstructive Tabaac, Ariella R. Jolly, Divya Boskey, Elizabeth R. Ganor, Oren Barriers to Gender-affirming Surgery Consultations in a Sample of Transmasculine Patients in Boston, Mass. |
title | Barriers to Gender-affirming Surgery Consultations in a Sample of Transmasculine Patients in Boston, Mass. |
title_full | Barriers to Gender-affirming Surgery Consultations in a Sample of Transmasculine Patients in Boston, Mass. |
title_fullStr | Barriers to Gender-affirming Surgery Consultations in a Sample of Transmasculine Patients in Boston, Mass. |
title_full_unstemmed | Barriers to Gender-affirming Surgery Consultations in a Sample of Transmasculine Patients in Boston, Mass. |
title_short | Barriers to Gender-affirming Surgery Consultations in a Sample of Transmasculine Patients in Boston, Mass. |
title_sort | barriers to gender-affirming surgery consultations in a sample of transmasculine patients in boston, mass. |
topic | Reconstructive |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7489736/ https://www.ncbi.nlm.nih.gov/pubmed/32983769 http://dx.doi.org/10.1097/GOX.0000000000003008 |
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