According to a survey of plastic surgeons, gender confirmation surgeries rose 19 percent in 2016 from the previous year, an increase some doctors attribute to expanded Medicare coverage and greater social acceptance of transgender people.
But less than 0.5 percent of those procedures involved the genitals, according to the survey of 703 doctors released on Monday by the American Society of Plastic Surgeons.
Gender confirmation surgery not only relates to gender reassignment surgery, which can include reshaping the genitalia but encompasses a number of procedures including operations on the chest or face.
“It’s a diverse population and there’s not a one-size-fits-all approach for caring for a transgender person. Not everybody wants every surgical option,” said Loren Schechter, a Chicago-based surgeon and member of the American Society of Plastic Surgeons.
He linked the increase to a 2014 decision by Medicare to end a blanket denial of coverage on gender transition related surgery and to changing societal attitudes toward transgender people and more positive images of them in the media.
The society publishes an annual statistics report on all types of plastic surgery and began reporting gender confirmation surgery for the first time this year.
They reported 3,256 surgeries, of which 54 percent were performed on male-to-female patients, or transgender women, and the remainder on female-to-male patients, or transgender men.
Among transgender women, 92 percent of the procedures were breast or chest operations, and 7 percent were facial.
Only 15 operations, or 0.9 percent, were on the genitals.
Among transgender men, there were zero genital operations reported.
Of all procedures on transgender men, 95 percent involved the breast or chest and 5 percent on the face.
Most transgender people forgo gender reassignment surgery, with only 11 percent of transgender women having had their testicles removed and 12 percent undergoing vaginoplasty, according to a landmark U.S. survey of nearly 28,000 transgender adults released last year by the National Center for Transgender Equality.
However, roughly half of transgender women said they would like to have such surgeries, that survey said, finding many lack the money or health insurance to cover costs.
The American Society of Plastic Surgeons said it represents 94 percent of all U.S. board-certified plastic surgeons. It could not assign a margin of error to the gender confirmation survey but said it applied the same methodology as it always has for its annual statistics report.