Grants Funded

Abstract
An estimated 0.6 percent of the United States population identifies as transgender. Many trans individuals opt for hormonal therapy and gender-affirming surgery in order to live as their preferred gender. According to the 2015 US Transgender Survey, one quarter of American transgender individuals have undergone some form of gender affirming surgery, and more than half would like some type of surgery in the future. Gender-affirming surgery includes gender mastectomy and phalloplasty in transmen and breast augmentation, facial feminization, and vaginoplasty in transwomen. The desire to undergo gender-affirming surgery has led to a four-fold increase in the number of these procedures in the US from 2012 to 2014. Despite the growing number of patients seeking gender-affirming surgery, the psychosocial and quality of life benefits of these procedures remain poorly studied, particularly among U.S. patient populations. Previous analyses have been limited by their small sample sizes, retrospective designs, and lack of patient reported outcome (PRO) measures. Furthermore, studies assessing PROs have mainly relied on ad hoc survey instruments. While the life changing nature of gender-affirming surgeries may seem evident to surgeons performing these procedures, prospective studies evaluating clinical and patient-reported outcomes are still needed to assist patients, providers, payers and policy-makers in making important decisions regarding these operations. Using a prospective study design with pre-/post-measures (specifically GAD-7, PHQ-9, Body Image Quality of Life Index, modified BREAST-Q, and the BODY-Q), we will conduct a pilot study evaluating clinical and patient-reported outcomes of gender mastectomy in transmen. We have already begun this study, with over 70 patients recruited in our pre-operative phase. We have also begun connecting with other sites in the hopes of creating a multi-center PRO study. The specific goals of this pilot study are as follows: 1) Establish a study process and selection of a standard panel of validated surveys for the study of gender affirming surgery in preparation for a larger multicenter study. 2) Collect pilot data on complication rates and patient-reported outcomes, specifically concerning anxiety, depression, body image, and health-related quality of life. Although we have started this project, we would like to hire a research assistant to help successfully recruit patients and see them postoperatively.

Biography
Dr. Megan Lane is a first year Plastic Surgery resident at the University of Michigan. Prior to beginning residency, she graduated in the top five students in her class at the University of Michigan Medical School. During medical school, she received both the prestigious honors of being in Alpha Omega Alpha as well as the Gold Humanism Society. She completed her undergraduate education at Washington University in St. Louis where she double majored in Women, Gender, and Sexuality Studies. She has published and presented on gender-affirming surgery over the past two years, and is interested in pursuing a clinical and academic career in this area. She has been working on the proposed research project for over a year, and currently mentors and manages a team of undergraduate and graduate students committed to this project. She also has expertise in the field of ethics, for which she has multiple publications and presentations.