Presentation Authors: Shyam Sukumar*, Debduth Pijush, Stanley Desire, Steven Brandes, New York, NY
Introduction: An increasing number of patients present for transgender care and gender affirming surgery (GAS) in the US. GAS is a multidisciplinary endeavor that usually includes specialists in genitourinary reconstruction. However, there is a paucity of data regarding contemporary practice patterns of GAS among Reconstructive Urologists.
Methods: An 18-question, email-based survey was sent to all members of the Society of Genitourinary Reconstructive Surgeons (GURS), using REDCap. Descriptive statistics and multivariable logistic regression models were used to assess factors influencing attitudes towards GAS.
Results: 304 GURS members were surveyed and 80 surveys returned. Results are shown in Table 1. 11% of the respondents were outside North America. 89% of respondents had seen a transgender patient in their practice in the preceding year, of whom 48% said that they did so because no one else in their practice would. Most respondents (76.3%) saw â‰¤10 transgender patients annually and for 90% of respondents this constituted â‰¤10% of practice volume. 50% of respondents said that their organization wanted to develop a multidisciplinary GAS program. Only 5% of respondents performed primary GAS and the most commonly performed GAS were procedures to correct complications of primary surgeries performed elsewhere (42.5%). 66% felt that they would like to pursue additional training in GAS. 75% of respondents felt that GAS should be a discipline within GURS. In multivariable modeling: working in an organization that wants a multidisciplinary program predicted for both the desire to pursue additional training in GAS (OR=1.55, p < 0.0001) and the belief that GAS should be a sub-discipline in GURS (OR=1.31, p=0.018). Age> 40 was the only predictor for a belief that GAS should not be covered by public insurance programs (OR=0.76, p=0.0107)
Conclusions: Most reconstructive urologists see a low volume of transgender patients. The majority of GAS performed are to repair complications of primary GAS performed elsewhere. Most respondents felt that GAS should be a discipline within GURS. Younger age and working for an organization that wants to develop a multidisciplinary GAS program are the main factors influencing positive attitudes towards GAS