{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T01:09:44Z","timestamp":1780103384503,"version":"3.54.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes, and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["R01DK137994"],"award-info":[{"award-number":["R01DK137994"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Understanding patient goals for metoidioplasty and phalloplasty gender-affirming surgery (MaPGAS) is paramount to achieving satisfactory, preference-sensitive outcomes, yet there is a lack of understanding of MaPGAS priorities and how these may vary between transgender men and non-binary individuals assigned female at birth (AFAB).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To understand the surgical goals of transgender men and non-binary individuals AFAB considering MaPGAS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>An online survey was created following literature review and qualitative interviews and distributed via social media and a community health center to participants AFAB aged \u226518\u00a0years who had considered but not yet undergone MaPGAS. We collected demographics, surgical history, Likert ratings of importance of 14 possible MaPGAS goals, and selection of the 5 most important goals. Differences in goal importance ratings were compared using the Mann\u2013Whitney U test. Responses to an open-ended question on additional MaPGAS goal considerations were thematically analyzed by 2 reviewers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>A total of 248 eligible participants completed the survey; participants included transgender men (64%) and non-binary individuals (36%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Both groups rated maintaining tactile and erogenous sensations as top priorities. Significant differences emerged in half of the goals, with transgender men more likely to place importance on being seen as male, public restroom comfort, peeing through the tip of the penis, standing urination through the fly, and resolution of gender dysphoria. Non-binary individuals were more likely to place importance on retaining a vaginal canal to receive penetration and for gender identity affirmation. These differences in goal prioritization between the 2 groups were most apparent when individuals provided their top 5 goals. In open-ended responses, aesthetics was a major consideration for transgender men, sexual pleasure was a consideration for non-binary individuals, and complications were cited as major concerns by both groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>Individual MaPGAS goals should be incorporated into preoperative counseling and may vary by gender identity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths and Limitations<\/jats:title>\n                  <jats:p>This is the largest study to our knowledge evaluating patient MaPGAS goals and comparing gender identity cohorts. Our results incorporate qualitative open-ended feedback and underscore the importance of understanding patient-specific MaPGAS goals to better facilitate personalized preoperative counseling. Results will be used to guide decision support tool development. Limitations include the cross-sectional study design and reduced socioeconomic diversity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>While maintaining tactile and erogenous sensation and minimizing surgical complications were universally important goals, significant variations emerged between transgender men and non-binary individuals\u2019 MaPGAS goals highlighting the need for personalized preoperative counseling.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdae193","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T03:35:53Z","timestamp":1738035353000},"page":"526-535","source":"Crossref","is-referenced-by-count":5,"title":["New insights into the goals of transgender male versus non-binary individuals considering metoidioplasty and phalloplasty gender-affirming surgery"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9573-8377","authenticated-orcid":false,"given":"Lee K","family":"Brown","sequence":"first","affiliation":[{"name":"Department of Surgery, Section of Urology, Dartmouth Hitchcock Medical Center , Lebanon, NH 03756,","place":["United States"]},{"name":"Geisel School of Medicine at Dartmouth , Hanover, NH 03755,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6316-4745","authenticated-orcid":false,"given":"Rebecca L","family":"Butcher","sequence":"additional","affiliation":[{"name":"The Center for Program Design and Evaluation (CPDE), The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College , Hanover, NH 03755,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda M","family":"Kinney","sequence":"additional","affiliation":[{"name":"The Center for Program Design and Evaluation (CPDE), The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College , Hanover, NH 03755,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John F","family":"Nigriny","sequence":"additional","affiliation":[{"name":"Geisel School of Medicine at Dartmouth , Hanover, NH 03755,","place":["United States"]},{"name":"Department of Surgery, Section of Plastic Surgery, Dartmouth Hitchcock Medical Center , Lebanon, NH 03756,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0380-3330","authenticated-orcid":false,"given":"Rachel A","family":"Moses","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Urology, Dartmouth Hitchcock Medical Center , Lebanon, NH 03756,","place":["United 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