MP02-20: A Systematic Review and Meta-Analysis of the effect of Gender-Affirming Pelvic Surgery on Gender Dysphoria and Body Image in Transgender Patients
Introduction: Transgender patients often demonstrate self-criticism and social distress related to body image dissatisfaction. Although patients seek gender affirming care to reduce gender dysphoria and improve body image, the degree to which these outcomes improve after “bottom” surgery (phalloplasty, metoidioplasty, vaginoplasty, vulvoplasty) has not been well quantified. Methods: Utilizing meta-analysis of observational studies in epidemiology (MOOSE) criteria, we performed a search of major biomedical databases for all relevant literature published regarding body image and gender dysphoria in transgender populations following bottom surgery from 1995 to 2001. Inclusion criteria included original research articles, studies of transgender patients receiving pelvic gender affirming surgery (phalloplasty, metoidoplasty, vaginoplasty, vulvoplasty), and use of either the Utrecht Gender Dysphoria Scale (UGDS) or Body Image Scale (BIS) scoring systems. Data were compiled using a comprehensive meta-analysis software (Revman). Pooled estimates were obtained using a random effects model with the generic inverse variance method. Results: Our literature search included 77 titles and 4 full articles. Four studies provided UGDS data. Our analysis of 208 patients revealed bottom-surgery resulted in significant improved in UGDS scores in patients compared to baseline with a standard mean difference of 6.74 (CI 6.24, 7.25; p<0.001). Three studies provided BIS data. Our analysis of 201 patients revealed bottom surgery resulted in significant improvements in body image satisfaction with a standard mean difference of 0.79 (CI 0.68, 0.91; p<0.001). Conclusions: Gender-affirming pelvic surgery was associated with significant improvements in body image satisfaction and a significant reduction in gender dysphoria among transgender patients. Our meta-analysis supports further use of gender-affirming surgical techniques to improve body image satisfaction in transgender populations. SOURCE OF Funding: UC San Diego School of Medicine Research Award
