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Transgender Physiology, Anatomy, and Aging: A Provider’s Guide to Gender-Affirming Surgeries

  • Cecilia T. Hardacker
  • Jules Chyten-Brennan
  • Alix Komar

Abstract

The purpose of this chapter is to explore the physiological and anatomical issues that affect older transgender, gender nonconforming (TGNC), and non-binary individuals who are eager to have gender-affirming surgery (GAS) later in life or individuals who have completed GAS and may be dealing with residual complications. Extensive barriers and issues of access exist for TGNC people who seek GAS throughout their lives. This chapter addresses access and insurance barriers to GAS, multiple chronic conditions of older transgender individuals compared to their cisgender counterparts, potential issues of polypharmacy and hormone therapy, and physical preoperative contraindications prior to top surgery, including breast augmentation or mastectomy, and bottom surgery, including vaginoplasty, phalloplasty, and metoidioplasty. Potential ramifications of long-term hormone use combined with chronic health conditions of aging create a unique set of health issues for TGNC individuals considering GAS in their later years. Primary care providers and geriatricians rarely study physiological and anatomical changes in terms of evaluating readiness of TGNC patients for surgery. This chapter explores care of aging TGNC individuals from the perspective of the provider who is eager to become familiar with persons who have had or wish to prepare for GAS. Most TGNC persons are likely to meet GAS criteria provided that any serious medical issues are well-managed.

Keywords

TGNC Aging Standards of care Chronic conditions Gender-affirming surgery Transgender Gender nonconforming Non-binary Vaginoplasty Phalloplasty Metoidioplasty 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Cecilia T. Hardacker
    • 1
  • Jules Chyten-Brennan
    • 2
  • Alix Komar
    • 3
  1. 1.Rush University College of NursingHoward Brown Health CentreChicagoUSA
  2. 2.Montefiore Medical CenterBronxUSA
  3. 3.Weiss HospitalChicagoUSA

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