Emotional quality-of-life after chest masculinizing surgery among transgender persons aged under versus over 18 years: a comparative observational study

This study aimed to compare emotional quality-of-life among young transgender men who underwent chest masculinizing surgery before or after the age of 18, with a minimum postoperative follow-up of two years. Secondary objectives included comparison of surgical satisfaction and variation of quality-of-life depending on the number of years since the surgery. This cross-sectional, multicenter study was conducted in France between February 1st, 2024, and July 31st, 2024. Participants were aged 16 to 25 years and had undergone chest masculinizing surgery at least two years prior to inclusion. They were divided into two groups according to age at surgery: those operated before 18 years and those operated after 18 years. Participants completed an anonymous online questionnaire including items from the “Pediatric Quality of Life Inventory” and the “Trans-Questionnaire”. Emotional quality-of-life, satisfaction with surgery, and variation of emotional quality-of-life depending on the number of years since surgery were assessed. Between-group comparisons were performed using Wilcoxon tests for continuous variables and Fisher’s exact tests for categorical variables. A p-value < 0.05 was considered significant. Forty-nine participants were included, with 22 individuals operated before the age 18 and 27 individuals operated after the age 18. The median follow-up period was 3.5 years. No significant difference in emotional quality-of-life was found between the groups (p = 0.47). There was no variation in quality-of-life scores according to time since surgery. Postoperative satisfaction was high: 100% of participants were satisfied with their chest appearance when dressed, 95% with their appearance when unclothed, 93% with scar location, and 91% with scar appearance.