Mental health and quality of life outcomes of gender-affirming surgery: A systematic literature review

Abstract

Introduction

Transgender individuals experience disproportionately higher rates of mental health concerns and lower quality of life (QoL) than the general population. Gender-affirming healthcare can reduce negative mental health outcomes and improve QoL. This review explores the mental health and QoL outcomes to accessing gender-affirming surgery for transgender individuals.

Method

Following the PRISMA guidelines, searches were conducted using five databases for peer-reviewed articles, in English, with full-text available online published between January 2000 and August 2021.

Result

Fifty-three studies were included. Findings indicate reduced rates of suicide attempts, anxiety, depression, and symptoms of gender dysphoria along with higher levels of life satisfaction, happiness and QoL after gender-affirming surgery. Some studies reported that initial QoL improvements post gender-affirming surgery were not always enduring.

Conclusion

This review supports the need for more sustainable and accessible gender-affirming surgery as a means for improving the mental health and overall QoL among transgender individuals and indicates the need for further research with greater methodological rigor focusing on correlates of positive gender-affirming surgical outcomes. Without social, legal, and public policy responses to transgender discrimination, marginalization and exclusion, the beneficial outcomes of improved gender-affirming surgery will remain unclear.

Keywords:

• Transgender
• gender-affirming surgery
• mental health
• quality of life
• preferred models of care

Disclosure statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) reported there is no funding associated with the work featured in this article.