Grants Funded

Abstract
Gender dysphoria can lead to dire physical and psychological sequelae resulting in drastic health disparities. Realigning the outward appearance of patients with gender dysphoria with their “true” gender improves patient health outcomes and quality of life, and is associated with minimal regret. Research points to gender transition as an effective treatment modality for gender dysphoria. Gender transition consists of psychiatric analysis, cross-hormone therapy, and gender-confirming surgery (GCS), but not all patients elect to progress through all aspects. The breadth of GCS includes facial feminization surgery (FFS), torso or “top” surgery, and genital or “bottom” surgery. Despite this wide range of surgical procedures, a majority of clinical outcomes studies of GCS have focused on body-based procedures, leaving a dearth of outcomes data on FFS. Retrospective studies demonstrated that FFS is associated with improved quality of life and perception of femininity. Unfortunately, there are no prospective studies analyzing outcomes of FFS, thus reducing the generalizability of the available data. In this study, we will prospectively assess patient perceptions of facial femininity, patient outcomes following FFS, and predictors of outcomes following FFS. We will also perform an in depth analysis of insurance coverage for patients undergoing FFS. A previously validated and reliable instrument for assessing perceptions of femininity and outcomes of FFS will be used in this study, and complemented with anthropometric and photogrammetric measurements. In this multi-center study between the University of Washington, the University of Michigan, and Brownstein and Crane Surgical Services, participants will be assessed pre-operatively, and then at one month and up to one year post-operatively. The University of Michigan and Brownstein and Crane Surgical Services are two pioneering institutions in FFS within academic and private practice plastic surgery, and will have access to a large patient population. Previous retrospective studies demonstrated vast differences in quality of life between gender dysphoric patients who had FFS relative to those who did not. We anticipate our study will evidence a substantial improvement in quality of life after FFS that will be more generalizable due to its prospective nature. Our results could further support the effects these life-altering procedures have on gender dysphoric patients and lead to standardization of FFS procedures.

Biography
While in Albania working for the World Health Organization, Shane met a child who’s trajectory in life was altered by a plastic surgeon who was able to repair her “buze lepurshi,” or cleft lip. Inspired by how a surgical intervention drastically affected the social aspects of a child’s life, Shane decided to pursue what he termed “surgical justice;” the use of technical surgical approaches to address social justice issues. He has since used his cumulative educational and research experiences to focus much of his interest on gender-confirming surgery within plastic surgery. As a plastic and reconstructive surgery resident at the University of Washington, he is honing his surgical and patient management abilities while pioneering research into the outcomes of gender-confirming surgery and education around transgender populations. Shane is a graduate of the University of Arizona, where he received a BS and MS in Biochemistry and Molecular Biophysics, and Stanford, where he received his MD. He has previously been awarded prestigious fellowships for research including Fulbright, Boren, and Howard Hughes Medical Research Fellowships.