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Weight stigma mitigating approaches to gender-affirming genital surgery

Plastic and Aesthetic Research 2022年第1期9卷 295-307页

作者： Elijah Castle Gaines Blasdel nabeel a.shakir Lee C.Zhao Rachel Bluebond-Langner Department of Urology New York University Langone Medical CenterNew YorkNY 10017USA Vattikuti Urology Institute Henry Ford Health SystemDetroitMI 48202USA Hansjörg Wyss Department of Plastic Surgery New York University Langone Medical CenterNew YorkNY 10017USA

The use of body mass index(BMI)to determine eligibility for gender-affirming surgery in transgender and nonbinary individuals has been *** BMI thresholds are often meant to be protective,restricting patients from access to surgery can also cause *** is a rationale for the continued use of BMI,but the inherent problems with it must also be recognized,including how weight stigma impacts patients’access to gender-affirming surgery and influences clinical *** article uses a narrative review of current literature to discuss how high BMI affects surgical outcomes in gender-affirming genital surgeries,as well as analogous procedures,existing de facto BMI thresholds,and how to both minimize the harms of proceeding with surgery in patients with a high BMI or the harms of delaying for weight *** factors into surgical decision-making based on the existing literature,which demonstrates that high BMI is associated with increased surgical risk,including higher incidences of surgical site infections and poor wound healing,as well as the possibility of free flap complications,which are a component of certain genital *** patient population is at higher risk for eating disorders,and it is prudent to find alternatives to requiring patient self-monitored weight *** impacts of weight stigma should be considered when treating gender-affirming surgery patients,and further data and research are needed to augment shared decision-making and lead to practice change.

关键词： Gender-affirming surgery weight stigma phalloplasty vaginoplasty metoidioplasty body mass index

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