Inclusive Healthcare Settings: Promoting Post-operative Follow-up in Transgender Voice Care through Awareness and Education - Abstract
Objectives: Gender-affirming laryngeal surgeries are becoming more common. Surgical outcomes for benign laryngeal disease are often affected by post-operative care. Documented barriers to medical care faced by transgender persons may affect their ability to participate in post-operative care visits and may affect their overall outcome. This study was initiated to compare the post-operative follow-up rates between patients who underwent gender-affirming laryngeal surgery and those who underwent voice surgery for non-neoplastic vocal fold lesions.
Methods: We conducted a retrospective chart review of patients who underwent laryngeal surgery for either gender-affirmation or non-neoplastic vocal fold lesions between January 2017 and June 2022. All post-operative visits were scheduled pre-operatively for both groups. The percentage of actual visits attended out of total visits scheduled was calculated. Standard statistical tests were performed to compare the groups. Results: The study included 228 patients; 30 underwent surgery for non-neoplastic vocal fold lesions, and 198 underwent gender-affirming laryngeal surgeries. The follow-up rate for patients who underwent gender-affirming laryngeal surgeries was 69.9%, and 58.1% for those who underwent non-neoplastic vocal fold lesion surgeries (p= .026). This significance was observed only when polypectomies were included in the analysis, whereas the follow-up rates for cyst and granuloma removal were similar to transgender individuals who underwent gender-affirming surgery. Conclusion: Despite known disparities and potential barriers to care, this study found that post-operative follow-up rates for transgender women were similar or slightly higher than those of cisgender patients who underwent removal of benign laryngeal disease. Future multi-centric studies are needed to evaluate the follow-up rates for other gender-affirming surgeries to identify potential disparities.