Pay more attention to mental health, recovery needs after gender-affirming surgery, study says

Additional surgical recovery and mental health needs remain largely unaddressed after gender-affirming surgery (GAS), a recent study has found. There is a need to pay greater attention to these post-GAS aftercare needs.

The study included 260 individuals who had undergone GAS in three large European institutions. All had undergone at least standard aftercare protocols. Through an online follow-up survey, participants rated the postsurgery care that they received and answered two open-ended questions, asking if they had other aftercare needs aside from those predefined in standard protocols and if there was anything they felt was lacking regarding aftercare in general.

Majority (65 percent; n=169) of the participants reported that they would have wanted additional postoperative care. In particular, 47 percent said they needed more assistance in terms of surgical recovery, while 36 percent highlighted the need for consultations with a mental health professional. Additionally, 20 percent said they also needed physiotherapy for the pelvic floor.

Thematic analysis of answers to the open-ended questions revealed four major domains: provision of care, additional psychological care, improvement of organization of care, and surgical technical care. As in the survey, the need for assistance in surgical recovery dominated answers, with respondents saying that they wanted clearer instructions regarding recovery and more information about the consequences of surgery.

Mental health needs were likewise frequently mentioned, further confirming the survey results. In particular, participants needed help in dealing with the side effects of surgery as well as with adjusting to life after GAS.

“In transgender healthcare, gender-affirming surgery is one of the cornerstones of medical transition to many treatment-seeking transgender individuals,” the researchers said. “Still, little is known about the aftercare needs of this group and how to bring these into practice.”

“This study investigated aftercare needs experienced by a large multicenter cohort … that had received GAS,” they added. “Nearly two-thirds of the participants from all three countries expressed the need for additional postoperative care, which is in line with the reported needs in nonclinical studies.” [J Clin Med 2019;8:749]