Gender-affirming surgery can be a life-changing experience for transgender individuals who wish to align their physical body with their gender identity. However, there are several important considerations to keep in mind when preparing for surgery, including whether or not to continue taking hormone therapy. Hormones, such as estrogen or testosterone, play a vital role in shaping the physical characteristics of the body and can have a significant impact on the outcome of surgery. In this post, we will explore the latest research on feminizing hormone therapy during gender-affirming surgery and discuss what you need to know to make an informed decision.
Gender-affirming surgery is an important step for transgender individuals who wish to align their physical body with their gender identity. For transgender women or those assigned the wrong sex at birth who identify as feminine, one crucial decision is whether to remain on estrogen hormone therapy before and after surgery. While some surgeons require patients to stop taking estrogen in preparation for surgery, recent research suggests that continuing estrogen therapy is safe and may even be beneficial.
In the past, it was widely believed that estrogen therapy increased the risk of blood clots, which could be dangerous during surgery. However, a recent study conducted at Mount Sinai Hospital in New York City found that transgender women who remained on estrogen therapy during gender-affirming surgery did not have a higher risk of blood clots than those who stopped taking estrogen before surgery. The study followed 919 transgender women who underwent surgery between 2000 and 2020 and found that the rate of blood clots was similar whether or not they continued estrogen therapy.
This is good news for transgender women who want to continue estrogen therapy before and after surgery. Estrogen therapy is important for maintaining feminizing effects, such as breast development and body fat redistribution. It also has psychological benefits, such as reducing anxiety and depression and improving quality of life. Discontinuing estrogen therapy before surgery can cause physical changes to reverse, which can be distressing for patients.
Some surgeons have been hesitant to allow patients to remain on estrogen therapy during surgery because they believe it could affect the outcome of the procedure. However, the Mount Sinai study found that there was no difference in surgical outcomes between patients who continued estrogen therapy and those who did not. The researchers concluded that “transgender women undergoing gender-affirming surgery can safely remain on estrogen therapy without an increased risk of venous thromboembolism or adverse surgical outcomes.”
It is worth noting that the study only looked at transgender women and not transgender men or non-binary individuals. More research is needed to determine the safety and efficacy of continuing hormone therapy during gender-affirming surgery for these populations.
The Mount Sinai study provides strong evidence that transgender women can safely continue estrogen therapy before and after gender-affirming surgery. This is an important decision that should be made in consultation with a healthcare provider who is knowledgeable about transgender healthcare. Patients should be aware that there may be some surgeons who still require hormone therapy to be discontinued before surgery, but the evidence suggests that this is not necessary for most patients. The decision to remain on estrogen therapy during surgery should be based on individual circumstances and medical history.
In conclusion, hormone therapy can be an important consideration for transgender individuals who are preparing for gender-affirming surgery. The decision to continue or discontinue hormone therapy should be made in consultation with a knowledgeable healthcare provider and based on individual circumstances and medical history. While some surgeons may require hormone therapy to be discontinued before surgery, recent research suggests that continuing hormone therapy is safe and may even be beneficial. By staying informed and working closely with your healthcare team, you can make the best decisions for your body and your health. Remember, gender-affirming surgery is a deeply personal decision, and there is no one-size-fits-all approach.
References
Dharmapuri, S., Goldenberg, D., & Ting, J. (2022). Transgender Women Can Safely Remain on Estrogen for Gender-Affirming Surgery. Endocrine Practice, 28(2), 106-112. doi: 10.1016/j.eprac.2021.09.008
Mount Sinai Health System. (2022, February 17). Study Supports a Change in Practice Allowing Patients to Remain on Estrogen for Gender-Affirming Surgery. Retrieved from https://physicians.mountsinai.org/news/study-supports-a-change-in-practice-allowing-patients-to-remain-on-estrogen-for-gender-affirming-surgery
Disclaimer: This blog offers general educational information and does not constitute professional advice or establish a therapist-client relationship. Please consult a healthcare provider for personalized guidance. Any decisions based on the content are the reader’s responsibility, and Clayre Sessoms Psychotherapy assumes no liability. All case studies are hypothetical with fictional names and do not reflect actual people. We prioritize your privacy and the confidentiality of all of our clients. We are committed to maintaining a safe, supportive space for 2SLGBTQIA+ community care.
