Transgender patients who get gender-affirming surgery to create more feminine facial features say it's a big boost to their mental health, a new study reports.
Researchers at the University of California, Los Angeles (UCLA), compared the mental health of 107 patients awaiting surgery to that of 62 individuals who had completed it roughly six months earlier. People who had received the procedure reported higher scores in seven of 11 measures of psychosocial health: anxiety; anger; depression; global mental health; positive moods; social isolation; and meaning and purpose.
Insurers often treat the gender-affirming facial surgery as cosmetic, in part due to a lack of evidence that it improves quality of life, the researchers noted.
"Access to facial gender-affirming surgeries under health insurance coverage in the U.S. is more limited than gender-affirming surgeries of other anatomic regions due to a lack of data on mental health quality-of-life outcomes," said lead author Dr. Justine Lee. She is an associate professor of surgery at UCLA's David Geffen School of Medicine.
"Our findings have the potential to change health insurance policies for the better for transgender patients," added Lee, who is also a consultant for Stryker, a manufacturer of medical equipment used for these surgeries.
The study indicated that gender-affirming surgery can be one of the most important procedures for patients suffering from gender dysphoria. That's a type of psychological distress that arises when the sex a person was assigned at birth doesn't align with their gender identity.
Transgender patients who were assigned male at birth often report their facial characteristics to be among their greatest sources of dysphoria.
"In the future, providers may want to consider incorporating psychosocial assessments over a period of time as a standard of care in the treatment of gender dysphoria," Lee said in a UCLA news release.
She added that a majority of patients seeking gender-affirming facial reconstruction are assigned male at birth and typically identify as female or nonbinary.
The reconstructive process, called facial feminization surgery, includes common procedures such as minimizing the brow bone area, reducing the jaw, altering the cheeks and reshaping the nose.
The new study indicates that even after adjusting for other factors like gender-affirming hormone therapy, pre-existing mental health diagnoses, social relationships or previous surgeries, the facial surgery alone was a standalone predictor of higher scores on the psychosocial health test.
The findings were published July 4 in the Annals of Surgery.
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SOURCE: University of California, Los Angeles Health Sciences, news release, July 4, 2022