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.
Lau BD, Levine A, Haider AH. Are Surgical Residents Prepared to Care for Transgender Patients?—Reply. JAMA Surg. 2018;153(1):93–94. doi:10.1001/jamasurg.2017.4025
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