Lightning Talk + Poster ESA-SRB-NZSE-CaSR 2026 in conjunction with ENSA

Journey to affirmation - review of a public masculinising chest surgery service (143587)

Zhiyuan Ma 1 , Sarina Lim 1 2 , David Handelsman 1 3
  1. Andrology Department, Concord Repatriation General Hospital, Concord, NSW, Australia
  2. Northern Clinical School, University of Sydney, Sydney, NSW, Australia
  3. ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia

Background and aims: Masculinising chest surgery represents an important part of gender affirmation for transgender men and gender diverse (TGD) individuals (1). However, access to this procedure remains limited, often results in significant distress, feeling of stagnation and high cost in the private sector(2-4). Commencing in September 2022 Concord Hospital is the only public hospital in NSW to have a multidisciplinary team providing this procedure. The aim of this study is to evaluate the outcome of referrals received since the program’s inception.

Methods: A prospective observational cohort study evaluating patient referrals for masculinising chest surgery since September 2022, with follow-up until the early post-op period. Patient demographics, medical history, waiting times and immediate post-operative outcome were summarised.

Results: From 309 referrals over three years and 9 months (6.9 referrals/month), 91 patients (29.4%) had surgery at time of writing (Figure 1). Patients had a median age of 22 years [interquartile range (IQR) 8] and came from many NSW local health districts. The median wait time from first visit to surgery was 17 months (IQR 10). Double incision mastectomy with free nipple graft was the most frequent (77%) surgical approach with immediate post-op complications rate of 25%, most was minor requiring no or minimal interventions (70%). Serious complications (eg large seroma or haematoma) were rare (n=5, 5.5%).

Conclusion: Masculinising chest surgery is the most sought-after gender affirming procedure among TGD. It carries a low risk of serious complications and unmet demand is high across the State with public availability restricted and private surgery very costly.  Expanded public access is required to make this procedure more readily available at both state and national levels to meet the growing demand.

 

Figure 1

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