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Preferences for Gender Affirming Treatment and Associated Factors Among Transgender People in Sweden

Axfors, Cathrine ; Iliadis, Stavros I. ; Rasmusson, Lovisa L. ; Beckman, Ulrika ; Fazekas, Attila ; Frisén, Louise ; Sandström, Lotta ; Thelin, Nils ; Wahlberg, Jeanette and Skalkidou, Alkistis , et al. (2023) In Sexuality Research and Social Policy 20(2). p.479-490
Abstract

Introduction: Gender affirming surgery of primary and/or secondary sex characteristics has been shown to alleviate gender dysphoria. A descriptive snapshot of current treatment preferences is useful to understand the needs of the transgender population seeking health care. This study aimed to describe preferences for gender affirming treatment, and their correlates, among individuals seeking health care for gender dysphoria in Sweden after major national legislative reforms. Methods: Cross-sectional study where transgender patients (n = 232) recruited from all six Gender Dysphoria centers in Sweden 2016–2019, answered a survey on treatment preferences and sociodemographic, health, and gender identity-related information during the same... (More)

Introduction: Gender affirming surgery of primary and/or secondary sex characteristics has been shown to alleviate gender dysphoria. A descriptive snapshot of current treatment preferences is useful to understand the needs of the transgender population seeking health care. This study aimed to describe preferences for gender affirming treatment, and their correlates, among individuals seeking health care for gender dysphoria in Sweden after major national legislative reforms. Methods: Cross-sectional study where transgender patients (n = 232) recruited from all six Gender Dysphoria centers in Sweden 2016–2019, answered a survey on treatment preferences and sociodemographic, health, and gender identity-related information during the same time-period. Factors associated with preferring top surgery (breast augmentation or mastectomy), genital surgery, and other surgery (e.g., facial surgery) were examined in univariable and multivariable regression analyses in the 197 people without prior such treatment. Main study outcomes were preferences for feminizing or masculinizing hormonal and surgical gender affirming treatment. Results: The proportion among birth assigned male and assigned female patients preferring top surgery was 55.6% and 88.7%, genital surgery 88.9% and 65.7%, and other surgery (e.g., facial surgery) 85.6% and 22.5%, respectively. Almost all participants (99.1%) wanted or had already received hormonal treatment and most (96.7%) wished for some kind of surgical treatment; 55.0% wanted both top and genital surgery. Preferring a binary pronoun (he/she) and factors indicating more severe gender incongruence were associated with a greater wish for surgical treatment. Participants with somatic comorbidities were less likely to want genital surgery, while aF with lacking social support were less likely to want internal genital surgery, in the multivariable analyses. Conclusions: In this sample of Swedish young adults seeking health care for gender dysphoria, preferences for treatment options varied according to perceived gender identity. Policy Implications: The study findings underline the need for individualized care and flexible gender affirming treatment options. The role of somatic comorbidities should be further explored, and support should be offered to transgender people in need. There is an unmet need for facial surgery among aM.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Gender confirmation procedures, Gender dysphoria, Gender identity, Health services for transgender persons, Transgender persons
in
Sexuality Research and Social Policy
volume
20
issue
2
pages
479 - 490
publisher
Springer
external identifiers
  • scopus:85116317565
ISSN
1868-9884
DOI
10.1007/s13178-021-00650-2
language
English
LU publication?
no
additional info
Publisher Copyright: © 2021, The Author(s).
id
6f4c8552-b55e-4ad5-9886-501c2fd36020
date added to LUP
2021-11-01 14:51:25
date last changed
2024-02-20 15:36:10
@article{6f4c8552-b55e-4ad5-9886-501c2fd36020,
  abstract     = {{<p>Introduction: Gender affirming surgery of primary and/or secondary sex characteristics has been shown to alleviate gender dysphoria. A descriptive snapshot of current treatment preferences is useful to understand the needs of the transgender population seeking health care. This study aimed to describe preferences for gender affirming treatment, and their correlates, among individuals seeking health care for gender dysphoria in Sweden after major national legislative reforms. Methods: Cross-sectional study where transgender patients (n = 232) recruited from all six Gender Dysphoria centers in Sweden 2016–2019, answered a survey on treatment preferences and sociodemographic, health, and gender identity-related information during the same time-period. Factors associated with preferring top surgery (breast augmentation or mastectomy), genital surgery, and other surgery (e.g., facial surgery) were examined in univariable and multivariable regression analyses in the 197 people without prior such treatment. Main study outcomes were preferences for feminizing or masculinizing hormonal and surgical gender affirming treatment. Results: The proportion among birth assigned male and assigned female patients preferring top surgery was 55.6% and 88.7%, genital surgery 88.9% and 65.7%, and other surgery (e.g., facial surgery) 85.6% and 22.5%, respectively. Almost all participants (99.1%) wanted or had already received hormonal treatment and most (96.7%) wished for some kind of surgical treatment; 55.0% wanted both top and genital surgery. Preferring a binary pronoun (he/she) and factors indicating more severe gender incongruence were associated with a greater wish for surgical treatment. Participants with somatic comorbidities were less likely to want genital surgery, while aF with lacking social support were less likely to want internal genital surgery, in the multivariable analyses. Conclusions: In this sample of Swedish young adults seeking health care for gender dysphoria, preferences for treatment options varied according to perceived gender identity. Policy Implications: The study findings underline the need for individualized care and flexible gender affirming treatment options. The role of somatic comorbidities should be further explored, and support should be offered to transgender people in need. There is an unmet need for facial surgery among aM.</p>}},
  author       = {{Axfors, Cathrine and Iliadis, Stavros I. and Rasmusson, Lovisa L. and Beckman, Ulrika and Fazekas, Attila and Frisén, Louise and Sandström, Lotta and Thelin, Nils and Wahlberg, Jeanette and Skalkidou, Alkistis and Papadopoulos, Fotios C.}},
  issn         = {{1868-9884}},
  keywords     = {{Gender confirmation procedures; Gender dysphoria; Gender identity; Health services for transgender persons; Transgender persons}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{479--490}},
  publisher    = {{Springer}},
  series       = {{Sexuality Research and Social Policy}},
  title        = {{Preferences for Gender Affirming Treatment and Associated Factors Among Transgender People in Sweden}},
  url          = {{http://dx.doi.org/10.1007/s13178-021-00650-2}},
  doi          = {{10.1007/s13178-021-00650-2}},
  volume       = {{20}},
  year         = {{2023}},
}