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Background <p>Gender-affirming facial surgery (GAFS) addresses gender dysphoria by aligning facial features with gender identity, with historical emphasis on refining the upper facial third to render patients more attractive and feminine. The GENDER-Q, a novel patient-reported outcome measure (PROM), evaluates aesthetic, functional, and psychosocial outcomes, complementing the Gender Preoccupation and Stability Questionnaire (GPSQ) to assess effects of GAFS in this study.</p> Methodology <p>Survey data from 86 patients was analyzed using GENDER-Q and GPSQ scores. Higher GENDER-Q scores indicated improved outcomes, whereas lower GPSQ scores reflected reduced gender dysphoria. Pre- and post-operative outcomes were compared using paired and unpaired t-tests. Spearman’s correlation coefficients assessed relationships between the parameters assessed.</p> Results <p>Significant improvements in post-operative GENDER-Q scores were observed across facial features, with upper face appearance (<i>r</i> = 0.54, <i>p</i> = 0.001), jaw (<i>r</i> = 0.49, <i>p</i> = 0.001), and chin (<i>r</i> = 0.48, <i>p</i> = 0.004), showing greatest gains. GPSQ scores decreased significantly (-7.77 ± 1.61, <i>p</i> &lt; 0.001). Pre- to post-operative changes of dysphoria, as measured by the GENDER-Q were associated with overall face (<i>r</i> = 0.62, <i>p</i> &lt; 0.001), upper face (<i>r</i> = 0.64, <i>p</i> &lt; 0.001), and chin (<i>r</i> = 0.51, <i>p</i> = 0.08) score improvement. Furthermore, increased overall facial satisfaction strongly correlated with improvement in satisfaction with the upper face (<i>r</i> = 0.54, <i>p</i> = 0.001), jaw (<i>r</i> = 0.49, <i>p</i> = 0.001), and chin (<i>r</i> = 0.48, <i>p</i> = 0.004).</p> Conclusions <p>An individualized approach to gender-affirming facial surgery that prioritizes overall facial harmony, rather than isolated subunit changes, improves gender congruence, facial satisfaction, and alleviates gender dysphoria in transgender patients. In addition, this study advocates for the use of tailored PROMs for the transgender population to more precisely capture and quantify the impact of population-specific interventions and conditions such as gender-affirming surgery and gender dysphoria respectively.</p>

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Patient satisfaction following gender affirming facial surgery: a GENDER-Q and gender preoccupation and stability questionnaire study (GPSQ)

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月4日

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  • Helia C. Hosseini,
  • Thayer J. Mukherjee,
  • Paula Flores-Perez,
  • Melanie Vassallo,
  • Jacqueline Ihnat,
  • Sasha Wood,
  • Kevin Hu,
  • Neil Parikh,
  • Omar Allam,
  • Michael Alperovich

摘要

Background

Gender-affirming facial surgery (GAFS) addresses gender dysphoria by aligning facial features with gender identity, with historical emphasis on refining the upper facial third to render patients more attractive and feminine. The GENDER-Q, a novel patient-reported outcome measure (PROM), evaluates aesthetic, functional, and psychosocial outcomes, complementing the Gender Preoccupation and Stability Questionnaire (GPSQ) to assess effects of GAFS in this study.

Methodology

Survey data from 86 patients was analyzed using GENDER-Q and GPSQ scores. Higher GENDER-Q scores indicated improved outcomes, whereas lower GPSQ scores reflected reduced gender dysphoria. Pre- and post-operative outcomes were compared using paired and unpaired t-tests. Spearman’s correlation coefficients assessed relationships between the parameters assessed.

Results

Significant improvements in post-operative GENDER-Q scores were observed across facial features, with upper face appearance (r = 0.54, p = 0.001), jaw (r = 0.49, p = 0.001), and chin (r = 0.48, p = 0.004), showing greatest gains. GPSQ scores decreased significantly (-7.77 ± 1.61, p < 0.001). Pre- to post-operative changes of dysphoria, as measured by the GENDER-Q were associated with overall face (r = 0.62, p < 0.001), upper face (r = 0.64, p < 0.001), and chin (r = 0.51, p = 0.08) score improvement. Furthermore, increased overall facial satisfaction strongly correlated with improvement in satisfaction with the upper face (r = 0.54, p = 0.001), jaw (r = 0.49, p = 0.001), and chin (r = 0.48, p = 0.004).

Conclusions

An individualized approach to gender-affirming facial surgery that prioritizes overall facial harmony, rather than isolated subunit changes, improves gender congruence, facial satisfaction, and alleviates gender dysphoria in transgender patients. In addition, this study advocates for the use of tailored PROMs for the transgender population to more precisely capture and quantify the impact of population-specific interventions and conditions such as gender-affirming surgery and gender dysphoria respectively.