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Gender-affirming surgeries dipped after pre-pandemic increase: research

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August 24, 2023
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Gender-affirming surgeries dipped after pre-pandemic increase: research
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Gender-affirming surgeries dipped in 2020 after nearly tripling in the years leading up to the pandemic, according to research published Wednesday.

The study, published in JAMA Network Open, found that the number of gender-affirming procedures performed in the U.S. increased from 4,552 in 2016 to 13,011 in 2019, before falling to 12,818 in 2020.

The decrease in procedures in 2020 was “likely reflective” of the COVID-19 pandemic, the study said. However, it also noted that the dip was “relatively modest,” especially since gender-affirming procedures are largely elective.

Despite the slight dip in 2020, the period from 2016 to 2020 still saw a larger increase in gender-affirming procedures than previous periods. 

While researchers noted that an earlier study found that the number of gender-affirming procedures performed in the U.S. nearly doubled from 2000 to 2005 and 2006 to 2011, they still increased almost threefold between 2016 and 2020, even with the dip from the pandemic.

The study also found that gender-affirming procedures were most common among patients between the ages of 19 and 30 and “relatively uncommon” among those age 18 and younger. 

About 52 percent of the patients who underwent gender-affirming surgery in the study were between 19 and 30 years old, and nearly 22 percent were 31 to 40 years old. Just 7.7 percent were between the ages of 12 and 18.

“In our cohort, fewer than 1200 patients in this age group underwent [gender-affirming surgery], even in the highest volume years,” the researchers noted. “[Gender-affirming surgery] in adolescents has been the focus of intense debate and led to legislative initiatives to limit access to these procedures in adolescents in several states.”

Twenty-two states have enacted bans on providing medication or surgical care to transgender youths, although the vast majority are tied up in legal battles, according to the Movement Advancement Project.

Different age groups also varied in the types of procedures they received, according to the study. Breast and chest procedures were more common among younger patients, while genital surgery was more common among older patients.

“In our cohort of individuals aged 19 to 30 years, breast and chest procedures were twice as common as genital procedures,” the study said. “Genital surgery gradually increased with advancing age, and these procedures became the most common in patients older than 40 years.”

“These trends likely reflect the increased complexity of genital surgery compared with breast and chest surgery as well as the definitive nature of removal of the reproductive organs,” it added.

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