Gender-affirming medical and surgical treatment experience in a multi-specialty transgender clinic from Tamil Nadu.

[PURPOSE] Transgender healthcare access is limited in India despite the availability of many healthcare professionals and tertiary care hospitals. We aimed to study the psycho-social, clinical, Gender-Affirming Hormone Therapy (GAHT), and Gender-Affirming Surgical (GAS) procedure experience in a multi-specialty transgender clinic.

[METHODS] This is an ambispective cohort study conducted over 3 years and 5 months in gender incongruence persons, who wished to undergo GAHT and GAS procedures. All were treated with appropriate GAHT before undergoing GAS. The psychological aspects were assessed by the Gender Preoccupation and Stability Questionnaire (GPSQ) and Becks Depression Inventory Questionnaire (BDI) before and 6 months after GAHT and GAS procedures.

[RESULTS] A total of 842 transgender individuals were studied. The mean age at presentation was 22 ± 6 for transgender females and 21 ± 5 for transgender males. A total of 220 GAS procedures were performed and the bilateral mastectomy was the most performed GAS procedure, in 65% (143 out of 220), followed by breast augmentation surgeries in 26% (59 out of 220). The other less commonly performed procedures were hysterectomy and bilateral salpingo-oophorectomy in 4% (9 out of 220), penectomy and orchidectomy in 2.2% (5 out of 220) and vaginoplasty in 1.8% (4 out of 220).

[CONCLUSION] Both GAHT and GAS procedures had improved the gender dysphoria and overall well-being of gender-incongruent individuals. The wide acceptance of transgender multi-speciality clinics is a convivial trend among transgender individuals to improve their healthcare access in India.