Long-Term Follow-Up of Gender-Affirming Chest Masculinization: What Have We Learned About Patient Satisfaction and Psychological Well-Being?

<b>Background:</b> Gender-affirming surgery has become an integral part of the gender transition process that transgender and gender-diverse individuals undergo. Although ample literature exists on the short-term outcomes of gender-affirming surgery, very little is known about the long-term implications the surgery has on the psychological well-being of the patients. The purpose was to understand the long-term impact that gender-affirming surgery has on transgender and gender-diverse individuals and gain insight on potential contributors to improved psychological well-being and satisfaction. <b>Methods:</b> All patients who were operated on by a single surgeon during a 20-year period were invited to the clinic for a follow-up appointment. The patients were physically examined, their scars were graded, and NAC sensation was evaluated. BUT (A and B) and BREAST-Q questionnaires were filled out by them and evaluated by the research staff. <b>Results:</b> Satisfaction with pre-operative information provided to the patient was associated with satisfaction with the final appearance of the chest (R = 0.717, <i>p</i> < 0.001), the surgical outcome (R = 0.481, <i>p</i> = 0.037), psychosocial well-being at follow up (R = 0.489, <i>p</i> = 0.034), satisfaction with the surgeon (R = 0.486, <i>p</i> = 0.035), satisfaction with the medical team (R = 0.62, <i>p</i> = 0.005) and satisfaction with the office staff (R = 0.65, <i>p</i> = 0.003). <b>Conclusions:</b> Pre-operative communication between the medical staff and the patients improves the psychological outcomes and satisfaction of the patients over the years.