Gender-affirming surgeries, which have well-established mental health benefits, were cancelled and delayed for transgender people worldwide during the COVID-19 crisis. Of 253 scheduled gender-affirming surgeries among transgender adults across 35 countries in late 2020, 27% (=69) reported that the COVID-19 crisis limited their access to gender-affirming surgery (i.e., cancelled, postponed indefinitely, or rescheduled). In adjusted models, respondents with reduced access to surgeries were somewhat more likely to screen positive for depressive or anxiety symptoms, whereas those who maintained access were more likely to report higher levels of happiness. Our findings illustrate the transgender-specific harms of the COVID-19 crisis on gender-affirming surgeries and mental health.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11456764PMC
http://dx.doi.org/10.1089/trgh.2022.0052DOI Listing

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Article Synopsis
  • Gender affirming surgeries help transgender and gender diverse individuals align their bodies with their gender identities, improving their mental health and overall wellbeing.
  • Regret rates after these surgeries are low, and they can enhance safety for transgender and gender diverse people in daily life.
  • The article reviews the types of surgeries, assessment protocols, and discusses the associated risks and benefits within the current U.S. sociopolitical context.
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Background: Some transgender and nonbinary people undergo phalloplasty and/or metoidioplasty as part of their medical transition process. Across surgical disciplines, a variety of resources are used to assist patients who are preparing for surgeries, including educational materials, workshops, peer support, and lifestyle changes. For gender-affirming surgeries, patients undergoing assessments to discern whether they are ready to undergo the surgery, and to assist them in achieving preparedness when needed.

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Transgender individuals commonly feel significant distress and discomfort, termed gender dysphoria, as a result of the discrepancy between their gender assigned at birth and their gender identity. A major source of gender dysphoria stems from distinct anatomical differences between the male and female chest. Gender-affirming mastectomy of transmasculine patients and breast augmentation for chest feminization of transfeminine patients, also referred to as top surgery, are often the first surgical interventions and most commonly pursued physical modifications for the treatment of gender dysphoria among this patient population.

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Defining a danger zone for iatrogenic long thoracic nerve injury in gender-affirming mastectomy.

J Plast Reconstr Aesthet Surg

January 2025

Oregon Health and Science University, Division of Plastic and Reconstructive Surgery, Portland, OR, USA; Oregon Health and Science University, Transgender Health Program, Portland, OR, USA. Electronic address:

The long thoracic nerve's (LTN) superficial location on the chest wall renders it vulnerable to iatrogenic injury. Plastic surgeons' gender-affirming mastectomy volumes are rapidly increasing. This operation involves lateral chest contouring placing the distal LTN at risk of injury along the chest wall.

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This historical narrative presents a comprehensive historical journey delving into the diverse facets of gender identity and expression across ancient cultures. It explores these civilizations' perspectives on gender diversity, highlighting instances that challenged conventional gender norms. Transitioning to the modern era, the narrative examines the dynamic landscape of LGBTQ+ and trans movements, spotlighting influential figures whose advocacy has significantly influenced societal perceptions and advanced the rights of gender diverse individuals.

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