ABSTRACT
Objective: Transgender and gender-nonbinary individuals (TGNB) are disproportionately impacted
by obesity. In addition to the associated health impact, obesity represents a significant
barrier to accessing gender-confirmation surgery (GCS). The purpose of this study
was to determine the prevalence of obesity among TGNB surgical candidates at an urban
academic medical center and evaluate the efficacy of self-monitored weight management.
Methods: The study was conducted at the Center for Transgender Medicine and Surgery at Mount
Sinai in New York City. Data abstraction from a quality improvement database was completed
for patients with a documented body mass index (BMI) and a GCS consult from October
2015 through February 2019. A total of 1,457 TGNB patients with a documented BMI and
a GCS consult in the historical period of review were included in analysis. Data were
abstracted to determine the prevalence of obesity among GCS candidates and evaluate
the current default pre-operative self-monitored weight management protocol.
Results: Of 1,457 TGNB patients, 382 (26%) were obese (BMI ≥30 kg/m2) at initial surgical consult. In addition, 369 (27%) were obese at a subsequent follow-up,
suggesting no statistically significant change in the rate of obesity among evaluated
TGNB despite self-monitored weight management (P = .5272).
Conclusion: Obesity is a significant barrier to gender affirming surgery for transgender individuals.
Self-monitored weight management is an unsuccessful strategy for improvement even
among individuals who would be predicted to be motivated.
Abbreviations: BMI = body mass index; CTMS = Center for Transgender Medicine and Surgery (at Mount Sinai); GCS = gender confirmation surgery; TGNB = transgender and gender-nonbinary
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Article Info
Publication History
Accepted:
August 11,
2019
Received:
July 24,
2019
Footnotes
DISCLOSURE
Dr. Safer served on an advisory panel for Endo Pharmaceuticals in 2018. The other authors have no multiplicity of interest to disclose.
DATA AVAILABILITY
The datasets generated during and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.
Identification
Copyright
© 2020 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
