Predictors of dilation difficulty in gender-affirming vaginoplasty.

A necessary component of postoperative care in gender-affirming vaginoplasty is the dilation of the neovaginal canal. Difficulty with dilation can cause patient pain and distress, often decreasing compliance and leading to partial or complete closure of the neovaginal canal. This study sought to evaluate the sociodemographic, operative, and comorbid characteristics that contribute to patient difficulty with neovaginal dilation.

Impact of intraoperative intravenous tranexamic acid on hematomas and bleeding events in gender-affirming vaginoplasty patients.

One of the more common and disruptive complications of gender-affirming vaginoplasty is postoperative bleeding. The present study aimed to evaluate the impact of intraoperative intravenous tranexamic acid (IV TXA) administration on postoperative bleeding events in a large sample of gender-affirming vaginoplasty patients. Patients undergoing gender-affirming vaginoplasty between June 2019 and July 2023 were evaluated retrospectively.

Assessing racial disparities in gender-affirming surgery utilization and hospital-level experience.

Racial and ethnic minority groups as well as gender minorities seeking gender-affirming care and surgery have historically had difficulties with healthcare access and experience. The intersection of these two groups may result in deficient healthcare for patients of minority racial and ethnic groups seeking gender-affirming surgery. This study sought to explore differences in gender-affirming genital surgery experience by race.

Hematospermia in a Transgender Woman with Evidence for Endometrial Tissue in the Prostate.

Background/objective: The frequency of hematospermia in transgender women is unknown. This report aimed to describe the development of hematospermia in a transgender woman.

Case Report: A 35-year-old transgender woman treated with estradiol valerate and leuprolide presented with painless rust-tinged ejaculate, urethral bleeding after ejaculation, and intermittent hematuria.

The Use of Injectable Estradiol in Transgender and Gender Diverse Adults: A Scoping Review of Dose and Serum Estradiol Levels.

Objective: Feminizing gender-affirming hormone therapy is the mainstay of treatment for many transgender and gender diverse people. Injectable estradiol preparations are recommended by the World Professional Association for Transgender Health Standards of Care 8 and the Endocrine Society guidelines. Many patients prefer this route of administration, but few studies have rigorously assessed optimal dosing or route.

Predictors of Unplanned Reoperation after Gender-affirming Mastectomy: An Analysis of the NSQIP Database.

Background: Gender-affirming mastectomy (GAM) is a gender-affirmation surgery designed to remove or reduce breast tissue, with or without nipple reconstruction. GAM is the most commonly performed gender-affirmation surgery and risk factors associated with unplanned return to the operating room and reoperation continue to be investigated. This is the largest study of transgender and nonbinary patients undergoing GAM to determine predictors of unplanned reoperation.

Estimate and needs of the transgender adult population: the SPoT study.

Background: Despite the increasing interest in transgender health research, to date little is known about the size of the transgender and gender diverse (TGD) population.

Methods: A web-based questionnaire survey was developed, including a collection of socio-demographic characteristics and disseminated online through social media. Gender incongruence was evaluated by using a 2-item approach assessing gender recorded at birth and gender identity.

Family Building in Transgender Patients: Modern Strategies with Assisted Reproductive Technology Treatment.

Purpose: Transgender and gender diverse (TGD) individuals continue to face adversity, stigma, and inequality, especially in health care. This study aimed to characterize the experience of TGD people and partners of TGD people with regard to fertility treatment.

Methods: All TGD patients presenting to a single academic center between 2013 and 2021 were included.

Gender-affirming care and endocrine-related cancers.

Abstract: With the increasing number of transgender and gender diverse (TGD) individuals who are seeking gender-affirming care, there is a clear need for the development and collection of evidence-based data to establish guidelines for patient care. TGD individuals are estimated to represent 0.3 to 4.

How Should a Transgender Patient's History of Deep Vein Thrombosis and Smoking Influence Gender-Affirming Health Decision Sharing?

This commentary on a case considers a transgender patient's mental health and risk for deep vein thrombosis (DVT) in ethical decision making about feminizing gender-affirming hormone therapy (GAHT). Key considerations when beginning GAHT include recognizing that venous thromboembolism risk may only be modest and can be easily mitigated and that a transgender patient's mental health status should not weigh in a treatment decision about hormone therapy any more than it would for someone who is not transgender. Because the DVT risk of the case patient, who has a history of smoking and DVT, will only be increased modestly if at all by estrogen therapy and can be decreased through smoking cessation along with other DVT prevention methods, the patient should receive gender-affirming hormone therapy.

Cancer in Transgender and Gender-Diverse Persons: A Review.

Importance: Transgender and gender-diverse individuals face unique challenges, including barriers to health care access and inequities in treatment, that may influence cancer risk and outcomes.

Observations: In this narrative review, a scoping review was conducted focusing on primary and secondary prevention and epidemiology of cancer, barriers to health care services, and health care practitioners' knowledge about specific issues pertaining to transgender and gender-diverse individuals. PubMed, the Cochrane Library, and Embase, were reviewed for citations from their inception to December 31, 2021.

The return of spermatogenesis in transgender women ceasing gender-affirming hormone therapy.

Fertility has become a priority in transgender health research. In this issue of Cell Reports Medicine, a study by de Nie et al. of nine transgender women demonstrates sperm production after the cessation of gender-affirming hormone therapy (GAHT).

The Mount Sinai Interdisciplinary Approach to Perioperative Care Improved the Patient Experience for Transgender Individuals.

Purpose: Although medical care for transgender and gender nonbinary (TGNB) individuals is rapidly expanding, numerous gaps in the organization of quality care for TGNB individuals remain. In 2018, the Mount Sinai Center for Transgender Medicine and Surgery (CTMS) expanded its unified care approach to integrate services with an interdisciplinary inpatient team for surgical patients as part of the program. The inpatient team connected with the existing interdisciplinary ambulatory team with all pertinent medical and psychosocial information shared between the teams.

An Analysis of Chaplains' Narrative Chart Notes Describing Spiritual Care Visits with Gender Affirmation Surgical Patients.

Purpose: The benefit of spiritual care for patients is well described, but little is known about the role of spiritual care in transgender and nonbinary patients recovering from gender affirming surgeries (GASs).

Methods: A single-center retrospective chart review was performed on patients who underwent GAS in 2017. Demographic information, surgery type, and chaplains' narrative notes were examined.

Medical considerations in the care of transgender and gender diverse patients with eating disorders.

Transgender and gender diverse (TGD) individuals are at increased risk for the development of eating disorders, but very little has been published with regards to the unique aspects of their medical care in eating disorder treatment. Providing gender affirming care is a critical component of culturally competent eating disorder treatment. This includes knowledge of gender affirming medical and surgical interventions and how such interventions may be impacted by eating disordered behaviors, as well as the role of such interventions in eating disorder treatment and recovery.

Update in Adult Transgender Medicine.

Transgender people often face barriers in health care due to lack of access to care, lack of knowledgeable healthcare professionals, discrimination, and gaps in medical and mental health research. Existing research on transgender health has focused heavily on mental health, HIV/AIDS, sexually transmitted diseases/infections, and substance abuse. Gender-affirming hormone therapy and/or surgery allows for some alignment of biology and gender identity.

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8.

Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health.

Gender- and Sexual Orientation- Based Inequities: Promoting Inclusion, Visibility, and Data Accuracy in Oncology.

Sexual and gender minority (SGM) people, including agender, asexual, bisexual, gay, gender diverse, genderqueer, genderfluid, intersex, lesbian, nonbinary, pansexual, queer, and transgender people, comprise approximately 10% or more of the U.S. population.