{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T04:54:48Z","timestamp":1782968088481,"version":"3.54.5"},"reference-count":40,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,9,3]],"date-time":"2021-09-03T00:00:00Z","timestamp":1630627200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Facial Plastic Surgery &amp; Aesthetic Medicine"],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives\/Hypothesis:<\/jats:title>\n                    <jats:p>The face is a major communicator of gender identity. Transfeminine individuals report debilitating quality-of-life deficits as a result of their gender dysphoria, which may be addressed with feminizing therapies. We aimed to quantify the potential impact of facial gender dysphoria experienced by transfeminine patients, as well as associated treatments, including feminizing facial gender surgery, through validated health state utility measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A transfeminine patient volunteer who underwent head and neck gender-affirming treatments was consented for research use of perioperative photographs. These media aided in the description of two transfeminine health states, pre- and postfacial feminization facial gender dysphoria. Monocular blindness and binocular blindness were two health state controls. General population adults rated these four health states through visual analog scale (VAS), standard gamble (SG), and time trade-off (TTO), which were used to calculate the quality-adjusted life years (QALYs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Survey respondents totaled 206 with a mean (standard deviation [SD]) age of 35.8 (11.9) years. Mean (SD) health utility measures included 0.75 (0.22) QALYs for VAS, 0.82 (0.19) QALYS for SG, 0.79 (0.21) QALYS for TTO for pretreatment facial gender dysphoria, and 0.81 (0.21), 0.86 (0.19), 0.83 (0.20) QALYS for postgender-affirming treatments for facial gender dysphoria. The health utility scores for the postgender-affirming treatments for facial gender dysphoria (+0.06 VAS,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.005) were significantly improved compared with the pretreatment state.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>To our knowledge, this study is the first to examine how the general population perceives the health burden of facial gender dysphoria experienced by transfeminine patients. Facial gender dysphoria is perceived to have a negative impact on health states, not dissimilar to monocular blindness in our sample. Feminizing facial gender surgery appears to significantly increase health utility measures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/fpsam.2020.0192","type":"journal-article","created":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T13:53:44Z","timestamp":1602770024000},"page":"350-356","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["The Health Burden of Transfeminine Facial Gender Dysphoria: An Analysis of Public Perception"],"prefix":"10.1177","volume":"23","author":[{"given":"Brian","family":"Nuyen","sequence":"first","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherian","family":"Kandathil","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniella","family":"McDonald","sequence":"additional","affiliation":[{"name":"Medical Scientist Training Program, San Diego School of Medicine, University of California, La Jolla, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Kaiser Permanente Northern California Medical Center, Oakland, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Kaiser Permanente Northern California Medical Center, Oakland, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam P.","family":"Most","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,9,3]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/15532739.2010.509215"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2015.11.010"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2019.02.004"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0000000000000232"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1068\/p220829"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21187"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0099483"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-010-9668-7"},{"key":"e_1_3_4_10_2","volume-title":"National Transgender Discrimination Survey Report on Health and Health Care","author":"Grant JM","year":"2010","unstructured":"Grant JM, , Mottet LA, , Tanis J, , Herman JL, , Harrison J, , Keisling M. 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