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Artikel

Combined hysterectomy and mastectomy surgery for transgender patients in an integrated health care setting  / Stephanie Cizek ... [et al.].

International Journal of Transgenderism, 18 (2017) 4 (okt-dec), p. 382-388
bron: International Journal of Transgenderism jaargang: 18 (2017) 4 (okt-dec), p. 382-388
samenvatting: Hysterectomy and mastectomy surgery for gender affirmation have traditionally been performed as separate surgeries. Our institution offers these surgeries as a single combined procedure, typically with same-day discharge. Decreasing the number of times patients need to have surgery may reduce barriers to care by limiting surgical and hospital stay events. Our primary objective was to describe the perioperative experience of transgender patients who underwent combined hysterectomy and mastectomy surgery. Methods: This retrospective case series assessed patients who underwent combined hysterectomy and mastectomy surgery between 2013 and 2015 in an integrated health care setting in the United States. Chart reviews were performed for outcomes of interest, which included operative and postoperative complications. Results: We identified 25 patients who underwent a combined hysterectomy and mastectomy for the indication of gender transition. Preoperative patient characteristics included a median age of 31, with a median BMI of 25. Ninety-two percent of the patients were on testosterone therapy at the time of surgery. A total of 76% and 24% of patients had laparoscopic and vaginal hysterectomies, respectively. Intraoperatively, the average blood loss was 104 mL, and there were no complications. Eighty percent of patients were discharged on the same day. Postoperatively, 92% of patients experienced no major complications. One patient received a uterine artery embolization and blood transfusion for postoperative intraabdominal bleeding, and one patient presented 9 weeks after surgery with partial vaginal cuff dehiscence requiring a cuff revision. There were no re-admissions within six months of surgery. There were no major mastectomy-related complications. Conclusions: Combined surgeries are feasible and reduce the number of surgical events and hospital stays. There were no complications that could be attributed to undergoing two procedures as a single incident.
onderwerpen:
signatuur: ts.
Combined hysterectomy and mastectomy surgery for transgender patients in an integrated health care setting
ts.
Stephanie Cizek ... [et al.].
International Journal of Transgenderism
18
(2017)
4
(okt-dec)
382-388
N302569
Artikel

Uterus transplantation as a fertility option in transgender healthcare  / Vikram G. Mookerjee & Daniel Kwan

International Journal of Transgender Health, 21 (2020) 2 (apr-jun), p. 122-124
bron: International Journal of Transgender Health jaargang: 21 (2020) 2 (apr-jun), p. 122-124
samenvatting: Many transgender and gender diverse people want to have children, but cross-sex hormone treatments limit fertility and complete gender affirming genital surgeries preclude it (Auer et al., 2018; Charter, Ussher, Perz, & Robinson, 2018; Kyweluk, Sajwani, & Chen, 2018). Stopping hormones requires foregoing gender affirming treatment, but cannot guarantee recovery of mature gametes. Cryopreserving gametes for in vitro fertilization (IVF) is more reliable, but it is costly and requires forecasting future fertility goals which are inherently stochastic. More importantly, since it necessitates gestational surrogacy, it disallows patients the fundamental experience of carrying a child, and though a technically straightforward solution to uterine infertility, it is not without emotional, social, and legal complications. Uterus transplantation (UTx) is currently being investigated for patients with absolute uterine factor infertility (AUFI) desiring pregnancy (Brännström et al., 2015; Ejzenberg et al., 2018). The Montreal Criteria, which are the international ethical standards governing UTx, require recipients to be genetically female (Lefkowitz, Edwards, & Balayla, 2013). The purpose of this editorial is to use the case-reasoning method of applied medical ethics to suggest consideration of UTx for transgender women.
onderwerpen:
signatuur: ts.
Uterus transplantation as a fertility option in transgender healthcare
ts.
Vikram G. Mookerjee & Daniel Kwan
International Journal of Transgender Health
21
(2020)
2
(apr-jun)
122-124
N307757
Artikel

Uterine transplantation and donation in transgender individuals; proof of concept  / Alireza Hamidian Jahromi ...[et al.].

International Journal of Transgender Health, 22 (2021) 4 oct-dec), p. 349-359
bron: International Journal of Transgender Health jaargang: 22 (2021) 4 oct-dec), p. 349-359
samenvatting: According to the Center for Disease Control (CDC)'s yearly Behavioral Risk Factor Surveillance System (BRFSS) report, approximately 25 million individuals worldwide, including -?1.4 million adults in the United States identify as transgender (Flores et al., 2020; Meerwijk & Sevelius, 2017). Estimated to comprise roughly 0.4?0.6% of the population, these numbers have been rising consistently, with a reported two-fold increase between the years 2011-2016 (Flores et al., 2020; Meerwijk & Sevelius, 2017). In recent years, decreased social stigmatization, improved insurance coverage, and expanded access to gender-affirmation surgery (GAS) (through the Affordable Care Act and commercial insurance plans (Baker, 2017; Wiegmann et al., 2021)) have resulted in an increase in the number of transgender individuals pursuing medical and surgical interventions (Berli et al., 2017; Wiegmann et al., 2021). For appropriately selected transgender individuals, GAS is safe, effective, and medically necessary (Coleman et al., 2012; Wierckx et al., 2011). Transgender women (TGW) may select from a variety of well-established therapeutic options which range from counseling and social role modifications, medical management in the form of gender-affirmation hormone therapy (GAHT), and a variety of GAS procedures. Among TGW treated with GAHT, approximately half will eventually undergo GAS (Kailas et al., 2017; Sineath et al., 2016). This includes genital surgery such as orchiectomy, penectomy, and vaginoplasty. In a recent study, Nolan et al. (2019) reported that 28% of TGW had undergone GAS procedures, 5?13% of these surgeries involved genital surgery. Of the TGW who had not yet undergone genital GAS (gGAS), 45?54% of respondents expressed interest in doing so in the future.
onderwerpen:
signatuur: ts.
Uterine transplantation and donation in transgender individuals; proof of concept
ts.
Alireza Hamidian Jahromi ...[et al.].
International Journal of Transgender Health
22
(2021)
4
oct-dec)
349-359
N311358
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