RESUMEN
PURPOSE: This study sought to prospectively examine the effects of gender-affirming chest reconstruction on gender congruence and chest dysphoria in transmasculine and nonbinary adolescents and young adults. METHODS: Individuals between the ages of 15-35 who were seeking gender-affirming chest surgery were enrolled as part of a broader, longitudinal study of transgender surgical experiences. Their chest dysphoria and gender congruence were measured at baseline, six months, and one year, using the Transgender Congruence and Chest Dysphoria scales. Repeated measures analysis of variance were used to detect differences in scores across assessment points. Where there were significant differences indicated, Tukey's honestly significant difference test was used to determine which differences in mean scores were significant between assessment points, as well as how results differed by demographic factors. RESULTS: The analytical sample consisted of 153 individuals who had completed both the baseline and at least one follow-up assessment - 36 (24%) endorsing a nonbinary gender and 59 (38%) under the age of 18. Repeated measures analysis of variance indicated significant differences in gender congruence, appearance congruence, and chest dysphoria between at least two assessment points for the total sample and each subgroup (binary/non-binary and adult/minor). Honestly significant difference tests indicated no significant differences between the postoperative assessments by age or binary gender. DISCUSSON: Gender-affirming chest reconstruction improves gender and appearance congruence and reduces chest dysphoria in both non-binary and binary populations of adolescents and young adults. These data support the need to improve access to gender-affirming chest reconstruction for adolescents and young adults and to remove legislative and other barriers to care.
Asunto(s)
Cirugía de Reasignación de Sexo , Personas Transgénero , Transexualidad , Adulto Joven , Humanos , Adolescente , Adulto , Estudios Longitudinales , Personas Transgénero/psicología , Identidad de GéneroRESUMEN
Although in most areas of practice, there is a reasonable expectation that doctors are sufficiently trained to offer care, this is not true in the case of gender-affirming procedures, which are not required learning in any surgical residency. At the current time, the field of gender surgery is too rapidly evolving, with available resources too scarce for fellowship or residency training to be a realistic requirement for offering these procedures, as the demand already outstrips the available workforce. However, patients are currently given too little information about surgeons' history with these procedures to provide truly informed consent. There is, as such, an ethical mandate to mold the culture of gender-affirming surgery such that surgeons are expected to routinely disclose relevant information about their training, experience, and outcomes to facilitate patient decision-making about care.
RESUMEN
During and after the 2016 United States (U.S.) presidential election, discriminatory policies and stigmatizing rhetoric have been increasingly directed toward the transgender community at state and national levels. Transgender and/or nonbinary (TNB) adolescents, already at elevated risk for poorer health relative to their cisgender (nontransgender) peers, may have been adversely impacted by the shifting sociopolitical climate. This secondary analysis used qualitative data from the Trans Teen and Family Narratives Project to investigate how perceived shifts in the sociopolitical climate following the 2016 election affected families with TNB adolescents in the New England region of the U.S. (states of Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont). Data included two waves of semistructured interviews conducted with TNB adolescents and their caregivers and siblings (N = 20 families, 60 family members). Two coders analyzed transcripts using a thematic analysis approach. Emergent themes included: contemporary life for trans people in America (e.g., being discriminated against and dehumanized), perceptions of the national sociopolitical climate (e.g., anger toward political figures), forms of resistance and advocacy (e.g., confronting misinformation), and factors amplifying or buffering effects of the sociopolitical climate (e.g., the formation of alliances or coalitions within the family). Findings indicate the 2016 election spurred the redefinition of communication boundaries within, and outside, the immediate family, particularly regarding online communication and social media. TNB adolescents and their families anxiously anticipated changes in the sociopolitical climate and their foreseen impact on TNB adolescents' rights and safety. Implications for family therapy, intervention design, and policy reform are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).