Top surgery dramatically improves quality of life for young trans adults, study finds
Top surgery dramatically improves the lives of trans adolescents and young adults, a first-of-its-kind study has found.
The study, published by researchers at the Northwestern University Feinberg School of Medicine, in Chicago, Illinois, in the peer-reviewed journal JAMA Pediatrics on Monday (26 September), looked at the quality of life and levels of dysphoria among young trans people following top surgery.
Scientists compared two groups of trans adolescents and young adults assigned female at birth between the ages of 13 and 24. The first, the treatment group, underwent either mastectomies or breast reduction surgeries, and the second, the control group, received gender-affirming care that did not involve surgery.
For fair comparison, each participant in the treatment group was “matched” with a person of similar age and who had spent a similar length of time on hormone treatment in the control group.
The outcomes of both having and not having top surgery were measured using the Chest Dysphoria Measure (CDM), as well as the Transgender Congruence Scale (TCS) and the Body Image Scale (BIS).
Unsurprisingly, they found that “gender-affirming top surgery is associated with improved chest dysphoria, gender congruence, and body image in this age group”.
‘Significantly improved quality of life’
One of the young people involved in the study, 18-year-old Martin, was 16 when he had top surgery, although it took his parents a while to accept the idea.
“At the time, it was difficult for me, because I didn’t really see my parents’ point of view. I just felt very uncomfortable in my body, and knew there were medical options to make me feel less uncomfortable,” he said.
“I didn’t necessarily feel rejected, but I felt discouraged. Now I realise that my parents weren’t unsupportive, they just hadn’t had the experience of having a trans child before.”
He said he felt it was “important” to contribute to the study, “especially if you have an experience that is unique or under-researched”.
“I hoped that by contributing to this study I could prove to other parents like my mom, who wanted to be supportive, that medical and surgical transition is healthy and safe and extremely helpful for people who choose to go down that path.”
The study will ‘inform physicians and parents’
Dr Sumanas Jordan, director of the gender pathways program at Northwestern Medicine and one of the authors of the study, said: “When we compared the outcomes of patients who received gender-affirming top surgery to those who did not, we recognised that surgery significantly improved the quality of life for patients.
“This has been well documented in adult patients, but until now it hasn’t been well described in teens and young adults. We hope the study will inform physicians and parents as they assess a youth’s readiness for gender-affirming medical or surgical treatment.”
Although this new research into trans youth’s quality of life after top surgery is unprecedented, studies have been carried out on the experiences of older trans and non-binary folks’ experiences, with similar results.
As far back as 2013, a British study found top surgery “acts as a prophylaxis against distress, ameliorates extant distress as well as providing improved quality of life and global functioning” for trans men.
In 2019, a study was published in the journal Plastic and Reconstructive Surgery, which found that “top surgery had major positive effects on all mental health and quality-of-life metrics” among trans adults, and 86 per cent of participants “reported improvement in gender dysphoria-related mental health conditions”.
More recently, a 2021 study from The University of California, San Francisco, which involved two follow up surveys found that trans men experienced “a significant improvement in quality of life 6 weeks and 1 year after chest surgery”.
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