Surgical Options for Patients Seeking Gender-Affirming Surgery

To describe the surgical treatments available to transgender women and men desiring gender-affirming surgery (GAS). Transgender patients who undergo GAS have high satisfaction and improved quality of life. Masculinizing procedures include chest reconstruction, facial masculinization surgeries, hysterectomy with bilateral salpingo-oophorectomy, metoidioplasty, and phalloplasty. Feminizing procedures include facial feminization surgeries, chondroplasty and voice surgeries, breast augmentation, orchiectomy, and genital surgeries, such as vaginoplasty and vulvoplasty. Vaginoplasty can be performed with inversion of penile skin, sigmoid colon, or peritoneal flaps. The most common GAS surgery in the United States is chest masculinization surgery. Major complications after penile-inversion vaginoplasty are infrequent. A wide range of surgical options exist for the treatment of gender dysphoria. In recent years, systematic reviews and meta-analysis data have shown high satisfaction and more consistent complication rates for GAS. Limited, multicenter data exist regarding surgical techniques, outcomes, and complications.