New Data on Gender-Affirming Surgery in the United States

A new study led by researchers at the Columbia University College of Physicians and Surgeons offers unique data on gender-affirming surgery in the United States.

The authors note that “gender dysphoria is characterized as an incongruence between an individual’s experienced or expressed gender and the gender that was assigned at birth. Transgender individuals may pursue multiple treatments, including behavioral therapy, hormonal therapy, and gender-affirming surgery (GAS).

“GAS encompasses a variety of procedures that align an individual patient’s gender identity with their physical appearance. While numerous surgical interventions can be considered GAS, the procedures have been broadly classified as breast and chest surgical procedures, facial and cosmetic interventions, and genital reconstructive surgery. Prior studies have shown that GAS is associated with improved quality of life, high rates of satisfaction, and a reduction in gender dysphoria.”

The study found that changes in federal and state laws mandating coverage of gender-affirming surgery may have led to an increase in the number of annual cases. The number of GAS in the United States increased from 4,552 in 2016 to 12,818 in 2020, nearly a threefold increase.

The data shows that a total of 48 019 patients underwent GAS during the period studies. The most common procedures were breast and chest procedures, which occurred in 27,187 patients (56.6%), followed by genital reconstruction 6,872 (35.1%) and other facial and cosmetic procedures 6,669 (13.9%). Overall, 25 099 patients (52.3%) were aged 19 to 30 years, 10 476 (21.8%) were aged 31 to 40, and 3,678 (7.7%) were aged 12 to 18 years. GAS for those in the younger age group has become a hot-button political issue. When stratified by the type of procedure performed, breast and chest procedures made up a greater percentage of the surgical interventions in younger patients, while genital surgical procedures were greater in older patients.