{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T21:23:10Z","timestamp":1788384190725,"version":"build-2803163510"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PCN Reports"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To understand the preferences of individuals with gender incongruence (GI) regarding gender\u2010affirming surgery (GAS), including gonadectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective, multicenter survey was conducted in Japan targeting individuals aged 18 years or older with GI who had not yet undergone GAS. Participants completed a questionnaire about their GAS preferences, desired surgical procedures, the reasons for their preferences, and willingness to undergo gonadectomy even if it was not legally required.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 107 participants (82 assigned female at birth [AFAB] and 25 assigned male at birth [AMAB]; median age: 31) participated in the study. Of those, 69% desired GAS, 29% did not, and 2% were undecided. The primary reasons for desiring GAS were the need for legal gender change (positive feelings: 62%, unavoidable: 24%), mental stability (56%), and reducing gender dysphoria (54%). Conversely, the main reasons for not wanting GAS were difficulty in securing funds for surgery (58%), followed by resistance to gonadectomy (41%). Of the 53 AFAB participants, 52 individuals desired hysterectomy and oophorectomy, and 26 wanted only this surgery. Among the 22 AMAB participants, 13 individuals desired vaginoplasty; however, five withdrew due to concerns about costs or postoperative complications. Even without legal requirements, 47% said they would choose gonadectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Reforming legal requirements for gonadectomy may alter the demand for or details of GAS in Japan, yet half of the participants still desire surgery. The primary reason for not undergoing surgery is the difficulty in securing funds, which is a significant finding.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pcn5.70207","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T13:00:12Z","timestamp":1758286812000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["What transgender individuals in Japan expect from gender\u2010affirming surgery: A multicenter prospective observational study"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7250-3381","authenticated-orcid":false,"given":"Wakako","family":"Yorozuya","sequence":"first","affiliation":[{"name":"Department of Urology Sapporo Medical University School of Medicine Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Ichihara","sequence":"additional","affiliation":[{"name":"Department of Urology Sapporo Medical University School of Medicine Sapporo Hokkaido Japan"},{"name":"Department of Urology Sapporo Central Hospital Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nodoka","family":"Kozen","sequence":"additional","affiliation":[{"name":"Department of Urology Sapporo Medical University School of Medicine Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teruo","family":"Abe","sequence":"additional","affiliation":[{"name":"Abe Mental Clinic Urayasu Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manabu","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Abe Mental Clinic Urayasu Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Niwa","sequence":"additional","affiliation":[{"name":"Nagumo Clinic Osaka Osaka Japan"},{"name":"Graduate School of Science and Technology Keio University Minato Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Baba","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Sapporo Medical University School of Medicine Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Utako","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Miyanomori Ladies' Clinic Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Nishikawa","sequence":"additional","affiliation":[{"name":"Rise Maruyama Clinic Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Medical Corporation Hokujinkai Miki Mental Clinic Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiaki","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Sapporo Medical University School of Medicine Sapporo Hokkaido Japan"},{"name":"Women's Medical Center, Tokeidai Memorial Hospital Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azusa","family":"Yamana","sequence":"additional","affiliation":[{"name":"Department of Urology Sapporo Medical University School of Medicine Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daito","family":"Nishiyama","sequence":"additional","affiliation":[{"name":"Department of Urology Sapporo Medical University School of Medicine Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Masumori","sequence":"additional","affiliation":[{"name":"Department of Urology Sapporo Medical University School of Medicine Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"e_1_2_13_2_1","first-page":"533","article-title":"Japanese Society of Psychiatry and Neurology, Special Committee on Gender Identity Disorder: report and recommendations on gender identity disorder","volume":"99","year":"1997","journal-title":"Psychiatr Neurol Jpn"},{"key":"e_1_2_13_3_1","volume-title":"Guidelines for the diagnosis and treatment of gender incongruence","year":"2024"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_13_5_1","volume-title":"ICD\u201011 (International Classification of Diseases, 11th Revision), the global standard for diagnostic health information","year":"2019"},{"key":"e_1_2_13_6_1","first-page":"113","article-title":"Judicial differences in decisions on gender change","volume":"16","author":"Nakagawa M","year":"2023","journal-title":"J GID 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