Subcutaneous Mastectomy Improves Satisfaction with the Body and Psychosocial Function in Trans Men; Findings of a Cross-Sectional Study Using the BODY-Q Chest Module

BACKGROUND: The effectiveness of gender confirming surgery is best evaluated on the basis of patient-reported outcomes such as appearance satisfaction and health-related quality of life. This is the first explorative study using the BODY-Q chest module, administered in trans men before and after mastectomy.

METHODS: Between October 2016 and May 2017, trans men were recruited to participate in a cross-sectional study. Data collection included standardized anamnesis and examination, screening questions on depression/anxiety, and seven BODY-Q scales, including new scales measuring satisfaction of the chest and nipples. Mean scores for pre- and post-operative participants were compared, and explorative regression analyses were conducted to identify factors associated with BODY-Q scores.

RESULTS: In total, 101 persons participated (89%; 50 pre-operative, 51 post-operative). Post-operative participants reported significantly higher (better) scores on the chest (M=67), nipple (M=58), body (M=58; t-tests, all p<.001) and psychological (M=60; t-test, p=.05) scales compared with pre-operative patients. Post-operative chest and nipple mean scores did not differ significantly from a gynecomastia comparison, whilst scores were less favorable on the psychosocial domains. Pre-operatively, chest scores were not associated with objective breast size. Lower post-operative chest scores were associated with planned revision surgery (β=-.52) and depressive symptoms (β=-.59) as indicated by the screening question.

CONCLUSIONS: The present findings indicate that chest and nipple satisfaction differences in trans men undergoing mastectomy can be detected using the BODY-Q chest module. Future prospective studies are needed to measure clinical change in satisfaction and how this relates to changes in other aspects of health-related quality of life.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.