Reported Pain in Cisgender Female and Transmasculine Patients Seeking Benign Breast Surgery

Benign breast surgery aims to treat the physical and psychological discomfort that may be associated with excess breast tissue. In this investigation, we present the first systematic examination and comparison of the determinants of pain and related symptomology in cisgender women and transmasculine individuals presenting for benign breast surgery. METHODS: To complete this study, we abstracted the intake forms of 128 transmasculine and 62 cisgender female patients who presented for benign breast surgery between August 2016 and July 2020. RESULTS: Increasing chest size was associated with significantly increased odds of reporting rash (OR 1.10 95% CI [1.01–1.10], P < 0.03), difficulty playing sports (OR 1.19 95% CI [1.09–1.29], P < 0.001), and difficulty finding clothes that fit (OR 1.21, 95% CI [1.11–1.33], P < 0.001). For individuals who bound their chests, size was also associated with difficulty exercising in a binder (OR 1.14 [1.01–1.29], P < 0.03). Looking separately at the two populations, the only factors that remained associated with pain in multivariate models were BMI (β = 0.10 [0.01–0.18], P < 0.03) for cisgender women and history of binding (β = 1.95 [0.37–3.52], P < 0.02) for transmasculine people. CONCLUSIONS: Pain does not seem to be associated with chest size in either cisgender female or transmasculine patients seeking benign breast surgery. The association between chest binding and pain in transmasculine people supports the provision of gender-affirming chest surgery to eliminate the need to bind and reduce both physical and psychological distress.