• Annals of surgery · Jul 2023

    Racial Disparities in the 30-Day Outcomes of Gender-Affirming Chest Surgeries.

    • Divya Jolly, Elizabeth R Boskey, and Oren Ganor.
    • Department of Plastic and Oral Surgery, Center for Gender Surgery, Boston Children's Hospital, Boston, MA.
    • Ann. Surg. 2023 Jul 1; 278 (1): e196e202e196-e202.

    ObjectiveTo determine if and how race impacts the 30-day outcomes of gender-affirming chest surgeries.BackgroundLittle is currently known about how race may affect the outcomes of gender-affirming surgeries.MethodsWe analyzed data from the National Surgical Quality Improvement Program (NSQIP) database of 30-day complications of gender-affirming chest surgeries from 2005 to 2019. All participants had a postoperative diagnosis code for gender dysphoria and at least one procedure code for bilateral mastectomy, bilateral breast reduction, or bilateral augmentation mammoplasty. Differences by racial group were analyzed through Pearson χ 2 and multivariate logistic regression.ResultsThere were no racial differences in the all-complication rates for both transmasculine and transfeminine individuals undergoing gender-affirming chest surgeries. Black patients undergoing masculinizing procedures were significantly more likely to experience mild systemic [adjusted odds ratio (aOR): 2.17, 95% confidence interval (CI): 1.02-4.65] and severe complications (aOR: 5.63, 95% CI: 1.99-15.98) when compared with White patients. Patients of unknown race had increased odds of experiencing severe complications for masculinizing procedures compared with White patients (aOR: 3.77, 95% CI: 1.39-10.24). Transmasculine individuals whose race was unknown were 1.98 times more likely (95% CI: 1.03-3.81) to experience an unplanned reoperation compared with White individuals. Black transfeminine individuals were 10.50 times more likely to experience an unplanned reoperation (95% CI: 1.15-95.51) than their White peers.ConclusionsAlthough overall complications are uncommon, there is evidence to suggest that there are racial disparities in certain 30-day outcomes of gender-affirming chest surgeries.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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