Postoperative Exercise Rehabilitation and Postural Outcomes Among Transgender Individuals Undergoing Chest Masculinization Surgery.

Purpose This pilot study evaluated the feasibility and initial effectiveness of a structured postoperative exercise rehabilitation program on postural outcomes for transgender individuals undergoing chest masculinization surgery (CMS). Methods A prospective cohort study was conducted at University of Illinois (UI) Health (Chicago, IL) from January to December 2023. Thirty-four participants (aged 18-25) were enrolled and divided into a rehabilitation group (n=20) and a standard care group (n=14). The rehabilitation group followed an eight-week exercise protocol targeting postural improvements, while the standard care group received no formal rehabilitation. Postural metrics, including wall-to-tragus and scapular tip distance, were measured preoperatively and at multiple postoperative intervals up to three months. Statistical analyses included Mann-Whitney U tests for continuous variables and Pearson's χ² tests for categorical variables. Results Adherence to the rehabilitation program was high, with eight participants (40%) reporting strong compliance. The rehabilitation group demonstrated a significant improvement in scapular tip distance (-2.69 cm, p=0.003), suggesting enhanced scapular retraction. Other postural metrics showed trends toward improvement but did not reach statistical significance. Qualitative feedback indicated high satisfaction with the rehabilitation program. Conclusion This study supports the feasibility and acceptability of a postoperative rehabilitation program for transgender individuals undergoing CMS. While improvements in posture were observed, larger studies with extended follow-up are needed to confirm these findings. Future research should also explore potential psychosocial benefits of postoperative rehabilitation in this population.