Association between genital gender-affirming surgery and psychiatric comorbidities in individuals with gender incongruence.

IF 3.3 3区医学 Q1 UROLOGY & NEPHROLOGY Journal of Sexual Medicine Pub Date : 2024-08-01 DOI:10.1093/jsxmed/qdae077

Kassra Garoosi, YooJin Yoon, Elijah Hale, Riley Kahan, Nargis Kalia, Ty Higuchi, David Mathes, Tyler Hudish, Christodoulos Kaoutzanis

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Abstract

Background: Previous studies present mixed evidence on the relationship between psychiatric comorbidities and genital gender-affirming surgery (GGAS) in individuals with gender incongruence (GI).

Aim: This research aims to investigate the psychiatric comorbidity rates post-GGAS in the GI population-namely, depressive disorders, anxiety disorders, posttraumatic stress disorders, substance abuse disorder, and suicidality.

Methods: Based on the TriNetX health care database, an international database with >250 million patients, a cross-sectional study was executed comparing psychiatric comorbidity rates among cases of GI with and without GGAS. Individuals were matched for demographic and health-related variables, which included history of cardiovascular disease, diabetes, and obesity.

Outcomes: The main focus was to establish the rates and changes in psychiatric comorbidities following GGAS.

Results: Among individuals with GI, the study identified 4061 with GGAS and 100 097 without. At 1 year post-GGAS, there was a significant decrease in depression (odds ratio [OR], 0.748; 95% CI, 0.672-0.833; P < .0001), anxiety (OR, 0.730; 95% CI, 0.658-0.810; P < .0001), substance use disorder (OR, 0.730; 95% CI, 0.658-0.810; P < .0001), and suicidality (OR, 0.530; 95% CI, 0.425-0.661; P < .0001), and these reductions were maintained or improved on at 5 years, including posttraumatic stress disorder (OR, 0.831; 95% CI, 0.704-0.981; P = .028).

Clinical implications: The findings indicate that GGAS may play a crucial role in diminishing psychiatric comorbidities among individuals with GI.

Strengths and limitations: This is the largest known study to evaluate the effect of GGAS on psychiatric comorbidities in the GI population, offering robust evidence. The reliance on the precision of CPT and ICD-10 codes for data extraction poses a limitation due to potential coding inaccuracies.

Conclusion: The evidence suggests a significant association between GGAS and reduced psychiatric comorbidities in individuals with GI.

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生殖器性别确认手术与性别不协调者的精神合并症之间的关系。

背景：目的：本研究旨在调查性别不协调（GI）人群接受生殖器性别确认手术（GGAS）后的精神合并症发病率，即抑郁障碍、焦虑障碍、创伤后应激障碍、药物滥用障碍和自杀倾向：基于 TriNetX 医疗保健数据库（一个拥有超过 2.5 亿名患者的国际数据库），我们开展了一项横断面研究，比较了有 GGAS 和无 GGAS 的消化道病例的精神病合并症发生率。研究人员对患者的人口统计学和健康相关变量（包括心血管疾病、糖尿病和肥胖症病史）进行了匹配：主要重点是确定 GGAS 后精神疾病的发病率和变化情况：结果：在患有消化道疾病的患者中，研究发现 4061 人患有 GGAS，100 097 人未患有 GGAS。在接受 GGAS 治疗 1 年后，抑郁症明显减少（几率比 [OR]，0.748；95% CI，0.672-0.833；P 临床意义：研究结果表明，GGAS 可在减少消化道疾病患者的精神并发症方面发挥重要作用：这是目前已知的评估 GGAS 对消化道疾病患者精神疾病合并症影响的最大规模研究，提供了有力的证据。由于可能存在编码不准确的问题，因此依赖于 CPT 和 ICD-10 编码的精确性来提取数据存在局限性：有证据表明，GGAS 与减少消化道疾病患者的精神疾病合并症之间存在重要关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Sexual Medicine 医学-泌尿学与肾脏学

CiteScore

6.20

自引率

5.70%

发文量

826

审稿时长

2-4 weeks

期刊介绍： The Journal of Sexual Medicine publishes multidisciplinary basic science and clinical research to define and understand the scientific basis of male, female, and couples sexual function and dysfunction. As an official journal of the International Society for Sexual Medicine and the International Society for the Study of Women''s Sexual Health, it provides healthcare professionals in sexual medicine with essential educational content and promotes the exchange of scientific information generated from experimental and clinical research. The Journal of Sexual Medicine includes basic science and clinical research studies in the psychologic and biologic aspects of male, female, and couples sexual function and dysfunction, and highlights new observations and research, results with innovative treatments and all other topics relevant to clinical sexual medicine. The objective of The Journal of Sexual Medicine is to serve as an interdisciplinary forum to integrate the exchange among disciplines concerned with the whole field of human sexuality. The journal accomplishes this objective by publishing original articles, as well as other scientific and educational documents that support the mission of the International Society for Sexual Medicine.