Guiding the conversation—types of regret after gender-affirming surgery and their associated etiologies
| Autor: | Asa Radix, Sasha K. Narayan, Rachel Bluebond-Langner, Angela Carter, Jess Guerriero, Randi Ettner, Sara Danker, Jens U. Berli, Gaines Blasdel, Loren S. Schechter, Rayisa Hontscharuk |
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| Rok vydání: | 2021 |
| Předmět: |
Original Article on Transgender Surgery
medicine.medical_specialty Descriptive statistics media_common.quotation_subject 030232 urology & nephrology Regret General Medicine Terminology Surgery 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Patient experience Transgender medicine Etiology Conversation Professional association Psychology media_common |
| Zdroj: | Ann Transl Med |
| ISSN: | 2305-5847 2305-5839 |
| Popis: | Background A rare, but consequential, risk of gender affirming surgery (GAS) is post-operative regret resulting in a request for surgical reversal. Studies on regret and surgical reversal are scarce, and there is no standard terminology regarding either etiology and/or classification of the various forms of regret. This study includes a survey of surgeons' experience with patient regret and requests for reversal surgery, a literature review on the topic of regret, and expert, consensus opinion designed to establish a classification system for the etiology and types of regret experienced by some patients. Methods This anonymous survey was sent to the 154 surgeons who registered for the 2016 World Professional Association for Transgender Health (WPATH) conference and the 2017 USPATH conference. Responses were analyzed using descriptive statistics. A MeSH search of the gender-affirming outcomes literature was performed on PubMed for relevant studies pertaining to regret. Original research and review studies that were thought to discuss regret were included for full text review. Results The literature is inconsistent regarding etiology and classification of regret following GAS. Of the 154 surgeons queried, 30% responded to our survey. Cumulatively, these respondents treated between 18,125 and 27,325 individuals. Fifty-seven percent of surgeons encountered at least one patient who expressed regret, with a total of 62 patients expressing regret (0.2-0.3%). Etiologies of regret were varied and classified as either: (I) true gender-related regret (42%), (II) social regret (37%), and (III) medical regret (8%). The surgeons' experience with patient regret and request for reversal was consistent with the existing literature. Conclusions In this study, regret following GAS was rare and was consistent with the existing literature. Regret can be classified as true gender-related regret, social regret and medical regret resulting from complications, function, pre-intervention decision making. Guidelines in transgender health should offer preventive strategies as well as treatment recommendations, should a patient experience regret. Future studies and scientific discourse are encouraged on this important topic. |
| Databáze: | OpenAIRE |
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