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Comment & Response
January 2018

Are Surgical Residents Prepared to Care for Transgender Patients?—Reply

Author Affiliations
  • 1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Division of Health Sciences Informatics, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 3The Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland
  • 4Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • 5Center for Surgery and Public Health, T. H. Chan School of Public Health, Boston, Massachusetts
  • 6Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts
JAMA Surg. 2018;153(1):93-94. doi:10.1001/jamasurg.2017.4025

In Reply We thank Morrison et al for their thoughtful comments. We agree that the delivery of high-quality, patient-centered gender confirmation care requires a multidisciplinary approach. We also agree that gender confirmation surgery requires great technical skill and that more formal training programs should be developed to teach and refine these surgical skills.

One of the main reasons we chose not to discuss gender confirmation surgery in our Viewpoint1 was to avoid perpetuating the misconception that the only surgery that transgender patients undergo is for the purpose of gender confirmation. In fact, most surgeons are more likely to encounter a transgender patient for reasons other than gender confirmation surgery. Transgender patients present with acute appendicitis and cholecystitis requiring emergency general surgery just as cisgender patients do. Gender confirmation surgeries, such as radial forearm flap phalloplasty or penile inversion vaginoplasty, are well-planned, scheduled procedures typically led by surgeons who have made gender confirmation surgery a substantial part of their practice.

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