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U.S. Trends in Gender-Affirming Surgery Explored

Last Updated: March 01, 2018.

About 11 percent of patient encounters with a diagnosis code of transsexualism or gender identity disorder involve gender-affirming surgery, and more than half are not covered by an insurance plan, according to a study published online Feb. 28 in JAMA Surgery.

THURSDAY, March 1, 2018 (HealthDay News) -- About 11 percent of patient encounters with a diagnosis code of transsexualism or gender identity disorder involve gender-affirming surgery, and more than half are not covered by an insurance plan, according to a study published online Feb. 28 in JAMA Surgery.

Joseph K. Canner, M.H.S., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues analyzed data from the National Inpatient Sample to examine the incidence and trends over time of gender-affirming surgical procedures. Demographics, health insurance plan, and type of surgery were compared between 2000-2005 and 2006-2011 and annually from 2012 to 2014.

The researchers identified 37,827 encounters with a diagnosis code of transsexualism or gender identity disorder. Overall, 10.9 percent of these encounters involved gender-affirming surgery; 56.3 percent of patients undergoing these procedures were not covered by a health insurance plan. There was an increase in the incidence of genital surgery over time, from 72 percent of patients who underwent gender-affirming procedures in 2000-2005 to 83.9 percent of patients who underwent gender-affirming procedures in 2006-2011. Compared with 2012-2013, in 2014 there was almost a three-fold increase in the number of patients seeking these procedures who were covered by Medicare or Medicaid (from 25 to 70).

"As coverage for these procedures increases, likely so will demand for qualified surgeons to perform them," the authors write.

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