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June 1, 2022

Training Surgery Residents in Gender-Affirming Surgery

Author Affiliations
  • 1Vanderbilt University School of Medicine, Nashville, Tennessee
  • 2Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
  • 3Biomedical Informatics and Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, Tennessee
JAMA Surg. 2022;157(8):651-652. doi:10.1001/jamasurg.2022.0673

As demand for gender-affirming care increases among transgender and gender-diverse (TGD) individuals, the US health care system is underprepared to provide it.1,2 Gender-affirming care is an umbrella term that encompasses medically necessary therapy for patients experiencing gender dysphoria. These interventions include pubertal suppression therapy, hormone therapy, and gender-affirming surgeries (GAS) such as breast augmentation and mastectomy (aka top surgery), vaginoplasty and phalloplasty (aka bottom surgery), glottoplasty (aka voice surgery), and craniofacial contouring. Although expanding health insurance coverage and a rising awareness of diversity, equity, and inclusion address structural inequities in access to GAS, the demand for surgeons trained in GAS is increasingly apparent.2,3 Accordingly, surgeon-educators in the fields of general surgery, plastic surgery, head and neck surgery, gynecologic surgery, and urological surgery have sought to increase GAS training in residency programs. This Viewpoint explores important considerations in establishing requirements for training surgeons in GAS and whether this training should be routine or optional.

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