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.