Many Undergo Genital Gender-Affirming Surgery Outside State of Residence

Out-of-pocket costs 49 percent higher for procedures performed outside versus in the state of residence

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WEDNESDAY, July 6, 2022 (HealthDay News) -- Fifty percent or more of patients undergoing genital gender-affirming surgery (GAS) undergo the procedure outside of their state of residence, with higher out-of-pocket (OOP) costs associated with procedures performed outside the state of residence, according to a study published online July 6 in JAMA Surgery.

Jae Downing, Ph.D., from the Oregon Health & Science University in Portland, and colleagues estimated OOP and total costs for GAS among commercially insured individuals and examined whether the costs differed for surgical procedures conducted in and outside of the person's state of residence. Data were included for 771 patients who underwent GAS (609 vaginoplasty; 162 phalloplasty).

The researchers found that 41 and 56 percent of those undergoing vaginoplasty underwent surgery in their state of residence and outside their state of residence, respectively, and 41 and 50 percent, respectively, underwent phalloplasty in and outside their state of residence. Due to missing data about the facility or residence, 3 and 9 percent of vaginoplasties and phalloplasties, respectively, could not be classified as in or out of state. OOP costs were 49 percent higher in association with procedures outside the state versus those done in the state of residence.

"We observed a frequent need for travel and substantial OOP and total costs for commercially insured patients undergoing vaginoplasty and phalloplasty in the U.S.," the authors write.

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