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Gender-Affirming Surgical History, Satisfaction, and Unmet Needs Among Transgender Adults

JAMA Network Open 10.1001/jamanetworkopen.2025.32494

September 18, 2025 at 11:00 AM EDT

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What is the prevalence of gender-affirming surgery (GAS), high surgical satisfaction, and barriers to GAS among transgender, nonbinary, and gender-diverse (TGD) adults, and what factors are associated with these outcomes?In this cross-sectional study of 2176 TGD adult primary care patients, 946 (44%) reported having GAS, 776 of these (82.0%) reported high surgical satisfaction, and 2073 participants (94.4%) encountered a barrier to GAS. GAS prevalence, satisfaction, and barriers differed between transmasculine and transfeminine patients.These findings suggest that there is an unmet need for GAS among TGD patients, warranting interventions to improve the availability and accessibility of these services.

Corresponding Author: David R. Pletta, PhD, MPH, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109 (dpletta@umich.edu).

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