Mastectomy Surgical Recommendations for Female-to-Male Transgender Patients, and a Discussion of Gender-Affirming Care for Gender-Dysphoric Adolescents

Introduction: Subcutaneous mastectomy (top surgery) in female-to-male patients is one of the most common procedures gender-dysphoric patients will undergo in order to live as their desired gender. Procedure: By consistently using the technique described in this article, surgeons can achieve consistent and aesthetically pleasing results. Complications are rare, but it is important to inform the patient that there may be issues related to bleeding, infection, wound healing, nipple necrosis (if using a graft), or dog ears. Discussion: Multiple states in the United States are seeking to ban this type of care and are even attempting to restrict health care for adults. These bans are being enacted despite carefully researched and written guidelines from major international organizations. By following these guidelines, physicians can provide safe and evidence-based care to adolescents. Conclusion: The evidence conclusively demonstrates that providing gender-affirming care to patients of all ages improves their mental health, reduces rates of depression, and decreases the risk of suicide.