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Topic

PROGRESS for phalloplasty and metoidioplasty: A trans community-designed study

Social Dimensions of Health

Date & location

• Monday, December 9, 2024
• 10:00 A.M.
• Virtual Defence

Examining Committee

Supervisory Committee

• Dr. Nathan Lachowsky, School of Public Health and Social Policy, University of Victoria (Supervisor)
• Dr. Aaron Devor, Department of Sociology, UVic (Co-Supervisor)
• Dr. Ayden Scheim, Department of Epidemiology and Biostatistics, Drexel University (Outside Member)

External Examiner

• Dr. Augustus Klein, Hunter College, City University of New York

Chair of Oral Examination

• Dr. Maureen Ryan, School of Nursing, UVic

Abstract

Some trans and nonbinary people access gender-affirming surgeries as part of their medical transition-related care. The gender-affirming surgeries of phalloplasty and metoidioplasty both alter existing genitals to add appearance or functionality similar to that of a natal penis. Phalloplasty accomplishes this with grafted tissues and metoidioplasty with existing hypertrophied clitoral tissues. Patients undergo these procedures for a number of reasons which may relate to a desire for reduction of gender or body-related dysphoria or increases in gender-related euphoria. Literature on patient-reported experiences and outcomes is lacking for these surgeries, rather, the majority of research addresses complication rates, aesthetic appearance of genitals and the ability of the penis to function as intended.

This dissertation begins to fill these gaps in literature about patient experiences. Within the methodological chapter of this dissertation, I detail the community-based participatory nature of the project which includes an explanation of the process for designing the survey and planning knowledge translation activities. It showcases how research led by and for trans communities can be useful for collecting novel data; it also describes the value added to research when community input is centered in the research process.

The first empirical chapter presents data from this project about factors associated with self-reported feelings of being prepared to undergo phalloplasty or metoidioplasty. In a multivariable regression analysis, self-reported utility of readiness assessment was associated with perceived preparedness. The last empirical chapter documents improved self-rated mental health among our sample. In this analysis, self-rated mental health at the time of survey completion was statistically significantly higher than recalled mental health prior to undergoing surgery. In a multivariable model, self-reported preparedness and surgical satisfaction were associated with self-reported improved mental health. Lastly a concluding chapter summarizes both the novel contributions and significance of this work in context.