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Clinical Outcomes of Gender-Affirming Surgery in Individuals With Connective Tissue Disorders
Journal article   Peer reviewed

Clinical Outcomes of Gender-Affirming Surgery in Individuals With Connective Tissue Disorders

Jennifer K. Shah, Justin M. Camacho, Danielle Eble, Chandler Hinson, Daniel Najafali, Heli S. Patel, Pin-Keng Shih, Rahim Nazerali and Shane D. Morrison
Annals of plastic surgery, v 94(5), pp 605-611
May 2025
PMID: 39903583

Abstract

Life Sciences & Biomedicine Science & Technology Surgery
Introduction Gender-affirming surgery (GAS) is a complex process that often requires multiple surgical operations and carries a complication risk that could be exacerbated by connective tissue disorders (CTDs). This study aims to investigate the association between CTD diagnosis and GAS outcomes. Methods Using the Merative MarketScan Research Databases, patients with gender dysphoria diagnoses who underwent GAS between 2007 and 2022 were identified. Among these, patients with diagnosed CTDs were identified. Demographics, comorbidities, and postoperative complications were recorded. Chi-squared, Shapiro-Wilk, Wilcoxon-Mann-Whitney, and multivariate logistic regression testing was used for statistical analysis. Results Of 7575 patients meeting criteria (mean age 29 +/- 10 years), 300 (4%) had CTD diagnoses. One or more postoperative complications were recorded in 9.8% of patients, without statistically significant difference between CTD and non-CTD patients. Additional simultaneous GAS procedures [odds ratio (OR) 2.02; P < 0.01], Elixhauser index scores of 3+ (OR 1.36; P = 0.010), and age >45 years (OR 1.47; P = 0.02) increased odds of experiencing complications following the index GAS procedure, while CTD diagnoses (P = 0.52) did not affect odds of experiencing complications. However, CTD diagnoses did elevate odds of readmission (OR 1.47; P = 0.046), as did multiple simultaneous GAS procedures (OR 2.66), Elixhauser index scores of 3+ (OR 3.72), and smoking (OR 2.18) (P < 0.01). Conclusions These findings suggest CTDs may impact some gender-affirming surgical outcomes, and careful preoperative evaluation and management of comorbidities is necessary to reduce the risk of complications and readmission in this population. Surgeons should continue to exercise caution when performing elective surgery on patients taking immunomodulatory medications.

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#5 Gender Equality
#3 Good Health and Well-Being

Source: SDGs in the Output

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Surgery
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