Genital Gender-Affirming Surgery Requests Outside the Binary: Unique Multidisciplinary Considerations for Transgender and Gender Diverse Patients

This study describes genital gender-affirming surgery (GGAS) requests made beyond the binary medical approach at our institution and our multidisciplinary response to adapt current surgical pathways. We reviewed all GGAS requests from January 2016 to February 2022 to determine the number of requests outside the historical binary model of surgical offerings (n = 227). With a paucity of guidelines and outcomes to guide providers, we offer a systematic and patient-centered multidisciplinary approach to surgical evaluation that encompasses the various ways gender dysphoria and incongruence present in people of different gender expressions.