For the first time, the American Society of Plastic Surgeons (ASPS) is reporting on the number of gender confirmation surgeries in the United States. ASPS—the world's largest plastic surgery organization—found that more than 3,200 transfeminine and transmasculine surgeries were performed in 2016. The procedures can include anything from facial and body contouring to gender reassignment surgeries.
"There is no one-size-fits-all approach to gender confirmation," said Loren Schechter, MD, a board-certified plastic surgeon based in Chicago. "There's a wide spectrum of surgeries that someone may choose to treat gender dysphoria, which is a disconnect between how an individual feels and what that person's anatomic characteristics are."
Access to gender confirmation procedures has improved in recent years. In just the first two years of collecting data, ASPS found the number of transgender-related surgeries rose nearly 20 percent from 2015 to 2016. "In the past several years, the number of transgender patients I've seen has grown exponentially," said Dr. Schechter. "Access to care has allowed more people to explore their options, and more doctors understand the needs of transgender patients."
Members of the American Society of Plastic Surgeons undergo intense training to help these patients address the incongruity between their bodies and the gender they know themselves to be.
"Surgical therapy is one component of the overall care of the individual," said Dr. Schechter. "It takes a team of experts across different disciplines working together to provide comprehensive care. I often partner with doctors who may prescribe treatments such as hormone therapy and mental health professionals who help patients through their transitions."
Choosing a team of experts can be a difficult path to navigate. ASPS President Debra Johnson, MD, a board-certified plastic surgeon in Sacramento, California, says it is crucial to choose a surgeon who is certified by the American Board of Plastic Surgery to ensure the highest safety and training standards.
"Board-certified plastic surgeons undergo rigorous training that is designed to not only provide the safest and best quality care, but also give patients a variety of options when it comes to gender affirming surgeries," said Dr. Johnson. "Our goal as plastic surgeons is to help get transgender patients to a place where they feel the most comfortable."
Gearah Goldstein worked with Dr. Schechter throughout her transition and says she had full confidence that she was in good hands. Goldstein knew from a very early age that that her gender did not align with her body. She now feels that she can live her life as the person she's always been.
"For transgender people, like myself, surgical options are a corrective treatment, not cosmetic," she said. "The types of surgeries someone has is very personal and private, and you wouldn't even know someone had surgery if you saw them walking down the street. It's not about how we're perceived by the public, but how we perceive ourselves."
Goldstein is now an advocate for transgender youth. She says everyone has a unique story, but that her experiences help her understand what someone with gender dysphoria is feeling and how it can become an unbearable burden. She says gender confirmation, whatever that means for the individual, can be truly life-changing.
"It has been a lifelong journey for me. Growing up, there wasn't even a word for transgender. There were no role models or anyone to tell me that I could do something about this feeling of being disconnected from the body I was born with," said Goldstein. "The reality that I lived through has allowed me to assure the next generation that there is nothing abnormal about what they're feeling."
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