Abstract

Gender-affirming top surgery is an important procedure for members of the 2SLGBTQIA+ community. There are currently no standardized aftercare recommendations nor consistent timelines for rehabilitation following top surgery. The purpose of our study was to measure patient-reported outcomes, including upper limb function, pain interference, neuropathic pain, embodiment, role limitations due to physical health, social functioning, and general health, in individuals receiving top surgery, over an 11-week rehabilitation program.

Forty-two gender diverse individuals from the general population participated. Participants started individualized rehabilitative aftercare 10-days post-operatively, which included one 60-minute treatment per week, for 11-weeks. The Disabilities of the Arm, Shoulder, and Hand scale (DASH) and 4 other questionnaires were completed prior to surgery, then again at weeks 1, 5, and 11 post-op. Separate repeated-measures analyses of variance (ANOVA) were used to identify differences in all measures among the 4 time points.

After top surgery individuals experience significant disruption to upper limb function, similar to other invasive upper extremity surgeries. During the rehabilitation, our participants experienced a significant statistical and clinical improvement in upper limb function while pain was not a limiting factor during the treatment. Participants reported avoiding about 3 less environments or social experiences which represents a clinically significant improvement in patient-reported embodiment.

The results of our study demonstrate the benefit of standard post-operative rehabilitative care in patients undergoing gender-affirming top surgery. The timeline for rehabilitative care used in this study can be applied, by qualified care providers, for future individuals who have undergone gender-affirming top surgery.