Mental health and quality of life outcomes of gender-affirming surgery: A systematic literature review

Abstract Introduction Transgender individuals experience disproportionately higher rates of mental health concerns and lower quality of life (QoL) than the general population. Gender-affirming healthcare can reduce negative mental health outcomes and improve QoL. This review explores the mental health and QoL outcomes to accessing gender-affirming surgery for transgender individuals. Method Following the PRISMA guidelines, searches were conducted using five databases for peer-reviewed articles, in English, with full-text available online published between January 2000 and August 2021. Result Fifty-three studies were included. Findings indicate reduced rates of suicide attempts, anxiety, depression, and symptoms of gender dysphoria along with higher levels of life satisfaction, happiness and QoL after gender-affirming surgery. Some studies reported that initial QoL improvements post gender-affirming surgery were not always enduring. Conclusion This review supports the need for more sustainable and accessible gender-affirming surgery as a means for improving the mental health and overall QoL among transgender individuals and indicates the need for further research with greater methodological rigor focusing on correlates of positive gender-affirming surgical outcomes. Without social, legal, and public policy responses to transgender discrimination, marginalization and exclusion, the beneficial outcomes of improved gender-affirming surgery will remain unclear.