In a groundbreaking article,1 Canner and coauthors present the results of a retrospective observational study that used the National Inpatient Sample to quantify incidence and longitudinal trends and provide basic demographics for a population of transgender patients.1 They found that the number of gender-affirming surgeries is increasing annually and that more of the surgeries are now being covered by Medicare or Medicaid than in previous years. The study’s strengths include its originality and comprehensive, longitudinal data set, and like much compelling research, their work is thought provoking and suggests many areas for future study.