Why Doctors and Plastic Surgeons Must Be Trained on Transgender Surgeries
The number of gender-affirmation surgeries on the rise in the U.S. and it is projected to rise as the years go by. If the latest research by The American Society of Plastic Surgeons is anything to go by, then the number of transgender-related surgeries has gone up by about 20% from 2015 to 2016.
Why the increase?
This spike in numbers could be due to two reasons, one being the progressive change in society’s attitude and outlook towards trans-genders. Along with this, many corporates and companies started offering heath coverage for transgender individuals, which included surgery and post-op benefits for their own employees – all to promote inclusive work cultures and retention of talents within the company. Other companies to offer similar coverage, then adopted what started small, with only a few companies. And this is now gaining now traction, for instance, Starbucks announced in June of 2018 that they would now offer an extended insurance plan for all their transgender employees.
The second development; the Affordable Care Act, made it unlawful for all chief health plans to reject transition-related care from their coverage. This Act made transgender insurance coverage beneficial to so many people and awarded better opportunities for transgender care throughout the nation. It also comprised of coverage for all care, which is related to gender reassignment, such as for gender-affirmation surgeries. Hence, these developments worked in tandem to prompt the sudden influx of demand for transgender-related surgeries.
Where the problem lies
The demand for such surgeries then collided with the lack of supply of well-trained, competent specialist surgeons in the country.Because of the shortage, transgenders are now looking at long surgery wait lists which can span anywhere between 2 to 4 years. This is only because of the shortage of surgeons in the field of urology and reconstructive surgery.
To make matters sadder, many undertrained surgeons have also started entering the specialty field to meet the demand and ear them some money. You can only imagine the ill effects and consequences of this. Several well-meaning people and prospective transgender patients had raised red flags while writing to the World Professional Association of Transgender Health regarding the issue and their health and wellbeing. The letter suggested creating unambiguous accreditation procedures for surgical affiliation within the professional world.
Why accrediting doctors is felt necessary
The letter also pointed out to a lack of provable information, which exists in this matter, and this enables inexperienced surgeons to gain entry within the transgender community minus any proper skill required to manage surgical complications, should they arise. Training and experience makes all the difference given that gender reassignment surgeries and related procedures are incredibly complex and need complete understanding of the components and nuances of pre and post op care. And unlike most surgeries, this can include hormone therapies, psychotherapy and possible procedures created specially to deal with potential complications following surgery. If not properly trained, the doctors could do more damage than good.
Now, with the increased demand, there is a clear need for access to experienced and credible transgender surgeons within the country. For this, developing a comprehensive training program which is focused explicitly on transgender surgery, would result in having experts who are highly specialized in the fields of reconstructive and plastic surgery and urology. This training need has to include the aspect of post and pre operative case. By not seeing to this, we might be putting patients at a risk of complication without ensuring that patient transitions are a complete success.
Patients also stand to benefit from transgender surgery specific board certification, which can provide validation to the community of their surgeons’ experience and training. As no such certification exists now, it is tough for the patients to figure out if their surgeon was truly credible. Till this happens, all patients seeking to undergo gender-affirmation surgery must verify individually their surgeons’ expertise, how long they have been in the filed and how many such similar surgeries has he/she performed.
It’s not is grey, as last year, new transgender-related surgical programs were launched, like the program at Hahnemann University Hospital which has started training surgeons to actively address the issue. This sure is progress. If we are to continue down this path, prospective transgender patients can easily and affordably access surgeons who are trained to handle their issues and complications, and of course, making their transition successful and less taxing.
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