Patient-Reported Outcomes and Body Mass Index in Adolescents and Young Adults After Gender-Affirming Chest Surgery: A Single-Center Cross-Sectional Study.

OBJECTIVE

To assess the impact of body mass index (BMI) on patient-reported outcomes after gender-affirming chest surgery in adolescents.

BACKGROUND

Despite most previous studies finding no association between BMI and patient-reported outcomes in adults undergoing gender-affirming chest surgery, BMI eligibility requirements remain widely used. Moreover, little data exists regarding the impact of BMI on these outcomes in adolescents.

METHODS

A cross-sectional, patient-reported outcome survey study was conducted at a pediatric hospital from April to July 2024. Eligible individuals were at least 1-year postoperative from gender-affirming chest surgery. The primary outcome was the effect of BMI on scores from 7 validated patient-reported outcome measures, including BODY-Q Chest and Nipple, Gender Congruence and Life Satisfaction, Satisfaction with Decision, and Decision Regret Scale, compared between adolescent and young adult cohorts.

RESULTS

Among 77 participants who completed the survey, 42 (54.5%) underwent surgery as adolescents and 35 (45.5%) as young adults. Patient-reported outcomes evaluating appearance satisfaction, psychosocial well-being, and decisional satisfaction were high, whereas decisional regret was low. Scores did not significantly differ between adolescent and young adult cohorts, and most patient-reported outcome measures were not significantly influenced by BMI.

CONCLUSION

After gender-affirming chest surgery, both adolescents and young adults reported high appearance satisfaction, psychosocial well-being, and decisional satisfaction, along with low decisional regret. For the majority of patient-reported outcomes, these positive results were not associated with BMI, suggesting that gender-affirming chest surgery is associated with high quality of life for adolescents and young adults regardless of BMI.