July 6, 2022
Jama Surgery

Spending and Out-of-Pocket Costs for Genital Gender-Affirming Surgery in the US

Jae Downing, Sarah K. Holt, Michael Cunetta, et al.

Is traveling out of state to undergo a genital gender-affirming surgery associated with higher out-of-pocket costs for patients compared with undergoing surgery in the state of residence?  In this cross-sectional study of 771 patients who underwent vaginoplasty or phalloplasty, undergoing surgery outside the patient’s state of residence was associated with significantly higher out-of-pocket costs compared with undergoing surgery in their state of residence. The findings suggest that health care practitioners should be aware of out-of-pocket expenses and the association of the location where surgery is performed with patients’ costs when possible.

May 11, 2022
Jama Network

Centering Transgender and Nonbinary Voices in Genital Gender-Affirming Surgery Research Prioritization

Geolani W. Dy; Gaines Blasdel; Jae M. Downing

Genital gender-affirming surgery (GAS) is an umbrella term used to describe reconstructive procedures aimed to alleviate dysphoria related to genital anatomy for transgender and nonbinary (TGNB) individuals. Demand for GAS has grown,1 yet research on how TGNB patients perceive quality of care and surgical outcomes is scant. Notably, existing GAS studies have lacked community engagement, which limits their utility and may perpetuate harmful research practices. High-quality comparative effectiveness research studies using a patient-centered approach are needed to inform shared decision-making, develop best techniques and perioperative management strategies, and identify gaps in payers’ decisions about coverage of GAS and ancillary care.

March 1, 2022
Current Sexual Health Reports

Community Engagement and Patient-Centered Implementation of Patient-Reported Outcome Measures (PROMs) in Gender Affirming Surgery: a Systematic Review

Emily K. Clennon, Leigh H. Martin, Sarah K. Fadich, Laura Zeigen, Gaines Blasdel, Craig Sineath & Geolani W. Dy

Analyze the utilization of patient-centered outcomes research (PCOR) methods in the literature containing patient-reported outcome measures (PROMs) for gender affirming surgery (GAS).

Sexual and gender minority (SGM) communities face stigma and discrimination that impact all aspects of health. To better understand and improve their urologic health outcomes, we must study SGM patients as a distinct population and pursue research on outcomes identified as priorities to SGM communities. Patient-centered outcomes research (PCOR) is a methodology which is increasingly familiar to urologists and is crucial to adequately addressing SGM health in future urological research. We review existing literature focused on urologic outcomes of SGM populations and highlight specific PCOR initiatives built on SGM community engagement.


Transgender and Nonbinary Surgery Allied Research Collective

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Support of TRANS ARC includes a PCORI (Patient-Centered Outcomes Research Institute) Engagement Award and Oregon Health & Science University

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