{
  "abstract": "Objective Masculinising chest surgery, also known as top surgery, is the most requested gender-affirming procedure among transgender and gender-diverse (TGD) adolescents, yet research on patient experiences remains limited. This study explored the experiences of TGD adolescents who were seeking or had undergone masculinising chest surgery.Design Qualitative secondary analysis using existing themes framework and data from the GENDER-Q (GQ) and GENDER-Q Youth (GQY) research programmes, which aim to develop comprehensive patient-reported outcome measures for gender-affirming care.Setting Participants were sampled from five high-volume gender-affirming care clinics, three in Canada and two in the United States. Interviews were conducted online.Participants 35 GQ and GQY participants aged 13–18 years who were assigned female at birth, identified as trans men or non-binary, and were pursuing (n=19) or had undergone (n=16) masculinising chest surgery.Results Three major themes emerged: chest appearance, health-related quality of life (HRQL) and gender practices. Most participants expected a flatter chest that aesthetically aligned with their gender identity. Presurgery participants anticipated that surgery would allow them to engage in previously avoided physical activities and would enhance their relationships. Postoperative participants reported increased physical activity, mental resilience, bodily connection and social comfort. Most reported binder use and related reliance or discomfort as motivators for pursuing surgery.Conclusions This study highlights the multidimensional experiences surrounding masculinising chest surgery on TGD adolescents with impacts on chest appearance, HRQL and gender practices. Centering adolescents’ perspectives, these findings underscore the importance of accessible, affirming surgical care and provide valuable insights for clinicians, policymakers and future research.",
  "authors": [
    {
      "affiliations": [
        "Women’s College Hospital, Toronto, Ontario, Canada"
      ],
      "name": "Kathleen Armstrong"
    },
    {
      "affiliations": [
        "University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada"
      ],
      "name": "Ivy Quan"
    },
    {
      "affiliations": [
        "Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada"
      ],
      "name": "Shelby L Kennedy"
    },
    {
      "affiliations": [
        "Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA"
      ],
      "name": "Manraj N Kaur"
    },
    {
      "affiliations": [
        "Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada"
      ],
      "name": "Sylvie D Cornacchi"
    },
    {
      "affiliations": [
        "Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada"
      ],
      "name": "Charlene Rae"
    },
    {
      "affiliations": [
        "Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada"
      ],
      "name": "Natasha Johnson"
    },
    {
      "affiliations": [
        "Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada",
        "Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada"
      ],
      "name": "Karine Khatchadourian"
    },
    {
      "affiliations": [
        "UC San Diego Health, San Diego, California, USA",
        "UC San Diego Health and Rady Children’s Health, San Diego, California, USA"
      ],
      "name": "Maja Marinkovic"
    },
    {
      "affiliations": [
        "Division of Adolescent Medicine, Department of Pediatrics, Seattle Children’s Hospital, Seattle, Washington, USA"
      ],
      "name": "Gina M Sequeira"
    },
    {
      "affiliations": [
        "Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada"
      ],
      "name": "Brenda Bradley"
    },
    {
      "affiliations": [
        "Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada"
      ],
      "name": "Kevin Cheung"
    },
    {
      "affiliations": [
        "Division of Plastic Surgery, Department of Surgery, Seattle Children’s Hospital, Seattle, Washington, USA",
        "Department of Urology, University of Washington Medical Center, Seattle, Washington, USA"
      ],
      "name": "Shane D Morrison"
    },
    {
      "affiliations": [
        "Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada"
      ],
      "name": "Anne F Klassen"
    }
  ],
  "title": "In their own words: experiences surrounding masculinising chest surgery among transgender and gender-diverse adolescents – a secondary analysis of GENDER-Q data",
  "uid": "df42b8b3-9752-5e26-ae18-db6427a81606"
}