Background : In accordance with World Professional Association for Transgender Health (WPATH) guidelines, patients are required to present letters from mental health professionals prior to gender affirming surgery (GAS) making the relationship between the mental health professional and the transgender patient an imperative component of surgical preparation. As gender surgeons, we sought to study this relationship in order to ensure that our patients are satisfied with the care they receive from mental health professionals prior to GAS. Therefore, we developed a study to assess their level of satisfaction with their mental health care providers and evaluate pre-operative emotional distress.
Methods : IRB approval was obtained to disseminate a validated patient satisfaction survey. Permission to modify and distribute this survey was granted by the original investigator. Adult transgender patients were recruited from a surgical clinic at University of Miami Hospital where they were consulting for GAS. Participants rated their satisfaction with their respective mental health professionals in specific domains—trust, communication, exploration of ideas, body language, and active listening—as well as overall satisfaction (maximum score 75). Emotional distress was measured by emotional thermometer score (ETS). Evaluation of cross-sectional data was performed with descriptive statistics, Wilcox-Mann-Whitney test, and Spearman’s bivariate correlation.
Results : 97 patients (TGW 52 ; TGM 45) completed the survey. Patients were highly satisfied (mean score 70.68, and this did not differ based up on the length of relationship with the mental health provider (p=0.72). Emotional distress decreased significantly as patient satisfaction with provider increased (r = -0.255 p=0.017). The duration of the relationship with mental health provider did not correlate significantly with emotional distress (p=.122).
Conclusions : Our results suggest that a transgender person’s emotional distress can be mitigated by a satisfying relationship with his or her mental health provider even in a short amount of time. Given that satisfaction with mental health providers prior to surgery tends to be favorable, surgeons can continue to encourage preoperative counseling.