‘It’s just one step, but it’s a good step’: Northwestern study shows gender-affirming surgery benefits in youth


Illustration by Olivia Abeyta

Northwestern Medicine recently published the first and only matched cohort study evaluating top surgery in youth. Results show the procedure improves quality of life and mental health.

Martha Contreras, Reporter

A new study conducted by Northwestern Medicine and two other Chicago institutions shows that gender-affirming surgery for transgender and nonbinary adolescents and young adults improves quality of life and mental health.

According to the first installment of the two-part study, published Sept. 26, individuals assigned female at birth who received top surgery reported statistically significant decreases in chest dysphoria and improvements in gender congruence and body image at three months post-surgery. Dysphoria is a persistent feeling of disconnect between gender identity and physical presentation, while gender congruence is a sense of euphoria toward gender and body image. 

“I’m hoping this (study) will provide the information necessary for lawmakers to make an informed decision based on the science,” Feinberg fourth-year student Daniel Sasson said. 

This legislative session, 20 states filed at least one ban limiting transgender medical care, according to Freedom for All Americans’ Legislative Tracker.

Sasson, who has contributed to other research on gender-affirming surgery, started working on the study when it began in 2019. 

Feinberg Prof. and Gender Pathways Program Director Dr. Sumanas Jordan is the lead author of the study. She said the most significant limitation of the study was the short period of time surveyed post-surgery, which several media outlets — including Fox News — critiqued. 

The second part of the study will analyze data one year post-surgery, Sasson said. The research team recently finished collecting data and is now examining the results.

Sasson said he immediately knew the study would be impactful, as it is the first to formally characterize outcomes for chest surgery patients.

The study is prospective, meaning it studies transgender youth throughout the process of top surgery, Jordan said. This made the study the first of its kind to evaluate the effect of the surgery in transgender youth to date. 

Jordan said the study is a good “starting point” to destigmatizing gender-affirming surgery. 

“Starting the conversation and good scientific inquiry about the things that we do is very important,” Jordan said. “Right now, there is so much controversy and people are polarized, and these things are based on emotions and opinions. This is science and medicine.”

Bienen sophomore Eli, who asked not to include his last name to protect his privacy, is in the process of scheduling chest-reduction surgery and said he is “cautiously optimistic” about the study. 

Eli, a transgender man, said broader discussions about top surgery and its impacts are essential in the fight for wider acceptance. However, given the current political climate, they also worry that people will weaponize the data instead.  

Legal concerns are one of many obstacles for individuals seeking gender-affirming surgery, Eli said. He wants everyone to be more informed about transgender issues, especially medical care providers. 

Although their therapist approved their gender-affirming chest surgery in late July, Eli said they have not been able to set a date for their procedure due to their health insurance’s consistent failure to provide information. They said they persistently called their health care provider Kaiser Permanente for months, but were constantly misguided by employees.   

Eli said it is difficult to manage his own uncertainty in an environment where his decisions are consistently questioned.

“So far it’s been,” Eli said, pausing,  “rocky. I just feel frustrated because I know that it is so close, but there’s obstacles that I don’t have control over and don’t have access to understanding how to get there.”

Jordan and Sasson said a primary goal of the study is to spread more information about gender-affirming surgery benefits, especially for patients, parents and surgeons. 

Sasson said he wants to help surgeons around the world gain the confidence to perform these procedures, and invalidate the legislative argument that there isn’t enough data on them.

“We owe it to our trans kids and our parents to provide the best care we can,” Jordan said.

Email: [email protected]

Twitter: @marthacontrerr 

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