Gastroenterology & Endoscopy News: Demand for Gender-Affirming Surgery Rises

Gastroenterology & Endoscopy News recently interviewed Maurice Garcia, MD, director of the Cedars-Sinai Transgender Surgery and Health Program, which offers individualized treatment for patients seeking transition-related healthcare.

As the article explains, there is a considerable demand for gender-affirming healthcare today. In fact, Garcia told Gastroenterology & Endoscopy News that Cedars-Sinai now has a two-year waitlist for transition procedures. Five years ago, however, transgender patients had few surgical options and most insurance companies didn’t cover the operations.

“At that time, most genital surgeries were done in private practices, under the radar, or patients would travel abroad where the costs for these procedures were typically much less,” Garcia told Gastroenterology & Endoscopy News. 

But in the US, Garcia told Gastroenterology & Endoscopy News, he became concerned about the high number of patients who sought him out to fix previous complications caused by other surgeons' techniques. Studies have shown the complication rates vary widely from a low of 15% to a high of 70%, depending on the surgeon's expertise and technique. 

Garcia took an active role in bringing about more options for patients and improving transition healthcare. In 2013, Garcia spent one-year training as a fellow at the University College London, where he learned standard approaches for  gender-affirming surgeries. The next year, the Department of Health and Human Services decided to remove the ban on Medicaid covering the cost of the procedures. Soon, some insurance companies followed suit.

When he returned to the U.S. in 2014, Garcia established a gender-affirming surgery program at the University of California, San Francisco and then moved to Cedars-Sinai to establish the health system's Transgender Surgery and Health Program. 

With an estimated 1.4 million adults in the United States who identify as transgender and only about a dozen programs dedicated to gender-affirming surgery, the needs are increasing for more surgeons trained in the complex procedures and for better access to care for transgender patients. 

At three recent professional conferences, Garcia and colleague Yosef Y. Nasseri, MD, shared results from a new minimally invasive technique in which they created part of a women's internal genitals by using tissue from her colon.

“This approach is a perfect example of the synergy that happens when surgeons who bring their own expertise come together,” Garcia said. “We all have to innovate, design new techniques and form unique collaborations to continue to advance the field.”

Click here to read the story from Gastroenterology & Endoscopy News.

Read more on the Cedars-Sinai Blog: Faces of Cedars-Sinai: Dr. Maurice Garcia, Transgender Surgeon