Imaging Findings in Transgender Patients after Gender-affirming Surgery.

Creator(s)

Justin T. Stowell
Frances W. Grimstad, Children's Mercy Hospital
Daniel L. Kirkpatrick
Elizabeth R. Brown
Richard A. Santucci
Curtis Crane
Amy K. Patel
Jordana Phillips
Marina A. Ferreira
Felipe R. Ferreira
Aroldo H. Ban
Ronaldo H. Baroni
Carol C. Wu
Kimberly A. Swan
Stephanie A. Scott
Kelli J. Andresen

Document Type

Article

Publication Date

9-2019

Identifier

DOI: 10.1148/rg.2019190010

Abstract

Gender-affirming surgeries expand the options for physical transition among transgender patients, those whose gender identity is incongruent with the sex assigned to them at birth. Growing medical insight, increasing public acceptance, and expanding insurance coverage have improved the access to and increased the demand for gender-affirming surgeries in the United States. Procedures for transgender women, those patients with feminine gender identity, include breast augmentation using implants and genital reconstruction with vaginoplasty. Some transgender women receive medically unapproved silicone injections for breast augmentation or other soft-tissue contouring procedures that can lead to disfigurement, silicone pulmonary embolism, systemic reactions, and even death. MRI is preferred over CT for postvaginoplasty evaluation given its superior tissue contrast resolution. Procedures for transgender men, patients with a masculine gender identity, include chest masculinization (mastectomy) and genital reconstruction (phalloplasty or metoidioplasty, scrotoplasty, and erectile device implantation). Urethrography is the standard imaging modality performed to evaluate neourethral patency and other complications, such as leaks and fistulas. Despite a sizeable growth in the surgical literature about gender-affirming surgeries and their outcomes, detailed descriptions of the imaging features following these surgeries remain sparse. Radiologists must be aware of the wide variety of anatomic and pathologic changes unique to patients who undergo gender-affirming surgeries to ensure accurate imaging interpretation.

Journal Title

Radiographics : a review publication of the Radiological Society of North America, Inc

Volume

39

Issue

5

First Page

1368

Last Page

1392

MeSH Keywords

Diagnostic Imaging; Female; Humans; Male; Sex Reassignment Procedures; Transgender Persons

Keywords

Diagnostic Imaging; Sex Reassignment Procedures; Transgender Persons

Recommended Citation

Stowell JT, Grimstad FW, Kirkpatrick DL, et al. Imaging Findings in Transgender Patients after Gender-affirming Surgery. Radiographics. 2019;39(5):1368-1392. doi:10.1148/rg.2019190010