Background: Gender affirming mastectomy surgery, also known as top surgery, is known to improve psychological health and quality of life for transgender and gender diverse patients, but little is known about effects on physical health. 1 This study examines how baseline demographics and gender affirming mastectomy surgery impact longer-term lifestyle behaviours.
Methods: Gender affirming mastectomy patients, aged 18+, were recruited from Women's College Hospital and McLean Clinic. A survey was administered preoperatively (T1), 4 months postoperatively (T2), and 1 year postoperatively (T3). The survey consisted of the Short Multidimensional Inventory Lifestyle Evaluation, a self-assessment tool. Data was analyzed with ANOVA, Kruskal Wallis, and Wilcoxon signed rank tests using RStudio.
Results: 288 patients were eligible and 234 patients consented. 166 completed the survey at T1 (71%). Patients with higher household incomes and education scored better (p=0.003; p=0.0003). Household income had the largest impact on social supports (p=0.03); higher education was associated with better diet and stress management (p=0.001; p=0.0004). 109 patients completed the survey at T2 (66%). The total score was equivalent (p=0.19). At T3, 103 patients completed the survey (62%). Between T1 and T3, the total score increased from 75.66 to 78.06 (p=0.003). The scores improved in nutrition (p=0.01), physical activity (p=0.03), stress management (p=0.001), restorative sleep (p=0.01), and environmental exposures (p=<0.01).
Conclusions: Social determinants of health can play a significant role in lifestyle behaviours in TGD patients. This study found long-term improvements between pre- and postoperative lifestyle behaviours and across several domains. Further research should examine effects of gender affirming surgery across a longer timeframe.
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