Mental health and quality of life outcomes of gender-affirming surgery: A systematic literature review

Article


Swan, Jaime, Phillips, Tania M., Sanders, Tait, Mullens, Amy B., Debattista, Joseph and Bromdal, Annette. 2023. "Mental health and quality of life outcomes of gender-affirming surgery: A systematic literature review." Journal of Gay and Lesbian Mental Health. 27 (1), pp. 2-45. https://doi.org/10.1080/19359705.2021.2016537
Article Title

Mental health and quality of life outcomes of gender-affirming surgery: A systematic literature review

ERA Journal ID124653
Article CategoryArticle
AuthorsSwan, Jaime (Author), Phillips, Tania M. (Author), Sanders, Tait (Author), Mullens, Amy B. (Author), Debattista, Joseph (Author) and Bromdal, Annette (Author)
Journal TitleJournal of Gay and Lesbian Mental Health
Journal Citation27 (1), pp. 2-45
Number of Pages44
Year2023
Place of PublicationUnited States
ISSN1935-9705
1935-9713
Digital Object Identifier (DOI)https://doi.org/10.1080/19359705.2021.2016537
Web Address (URL)https://www.tandfonline.com/doi/full/10.1080/19359705.2021.2016537
Abstract

Introduction: Transgender individuals experience disproportionately higher rates of mental health concerns and lower quality of life (QoL) than the general population. Gender-affirming healthcare can reduce negative mental health outcomes and improve QoL. This review explores the mental health and QoL outcomes to accessing gender-affirming surgery for transgender individuals. Method: Following the PRISMA guidelines, searches were conducted using five databases for peer-reviewed articles, in English, with full-text available online published between January 2000 and August 2021. Result: 53 studies were included. Findings indicate reduced rates of suicide attempts, anxiety, depression, and symptoms of gender dysphoria along with higher levels of life satisfaction, happiness and QoL after gender-affirming surgery. Some studies reported that initial QoL improvements post gender-affirming surgery were not always enduring. Conclusion: This review supports the need for more sustainable and accessible gender-affirming surgery as a means for improving the mental health and overall QoL among transgender individuals and indicates the need for further research with greater methodological rigor focusing on correlates of positive gender-affirming surgical outcomes. Without social, legal, and public policy responses to transgender discrimination, marginalization and exclusion, the beneficial outcomes of improved gender-affirming surgery will remain unclear.

Keywordsgender-affirming surgery; mental health; preferred models of care; quality of life; Transgender
ANZSRC Field of Research 2020420603. Health promotion
440508. Transgender studies
520502. Gender psychology
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Institution of OriginUniversity of Southern Queensland
Byline AffiliationsSchool of Psychology and Counselling
Department of Health, Queensland
School of Education
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Point-of-care testing (POCT) for HIV/STI targeting MSM in regional Australia at community ‘beat’ locations
Mullens, Amy, Duyker, Josh, Brownlow, Charlotte, Lemoire, Jime, Daken, Kirstie and Gow, Jeff. 2019. "Point-of-care testing (POCT) for HIV/STI targeting MSM in regional Australia at community ‘beat’ locations." BMC Health Services Research. 19 (93), pp. 1-10. https://doi.org/10.1186/s12913-019-3899-2
Memoirs and manifestos for early career researchers in gender and sexuality education research
Coll, Leanne, van Leent, Lisa and Bromdal, Annette. 2019. "Memoirs and manifestos for early career researchers in gender and sexuality education research." Jones, Tiffany, Coll, Leanne, van Leent, Lisa and Taylor, Yvette (ed.) Uplifting gender and sexuality education research. Cham, Switzerland. Palgrave Macmillan. pp. 279-302
Homophobia, transphobia, young people and the question of responsibility
Rasmussen, Mary Lou, Sanjakdar, Fida, Allen, Louisa, Quinlivan, Kathleen and Bromdal, Annette. 2018. "Homophobia, transphobia, young people and the question of responsibility." Halse, Christine, Hartung, Catherine and Wright, Jan (ed.) Responsibility and responsibilisation in education. Abingdon, UK. Routledge. pp. 30-42
Recommendations and practices for holistic chronic obstructive pulmonary disease (COPD) assessment and optimal referral patterns in emergency department presentations: a scoping review protocol
Moloney, Clint, Beccaria, Gavin, Mullens, Amy, Issac, Hancy and Phillips, Tania. 2019. "Recommendations and practices for holistic chronic obstructive pulmonary disease (COPD) assessment and optimal referral patterns in emergency department presentations: a scoping review protocol ." BMJ Open. 9 (8), pp. 1-5. https://doi.org/10.1136/bmjopen-2019-030358
Substance-related expectancies mediate relationships between substance use (stimulants, alcohol) and condomless anal sex among men
Mullens, Amy, Fein, Erich, Ray, Madeleine and Young, Ross. 2018. "Substance-related expectancies mediate relationships between substance use (stimulants, alcohol) and condomless anal sex among men." International Journal of Behavioral Medicine. 25 (1 (Supplement)), p. S172.
Experiences of transgender prisoners and their knowledge, attitudes and practices regarding sexual behaviours and HIV/STIs: a systematic review
Mullens, Amy, Bromdal, Annette, Phillips, Tania and Gow, Jeff. 2018. "Experiences of transgender prisoners and their knowledge, attitudes and practices regarding sexual behaviours and HIV/STIs: a systematic review." International Journal of Behavioral Medicine. 25, p. S42.
The experience of psychological distress, symptoms of trauma, coping and post-traumatic growth in parents of children with congenital heart disease: a systematic review of the literature
Mullens, Amy and Brown, Jodie. 2018. "The experience of psychological distress, symptoms of trauma, coping and post-traumatic growth in parents of children with congenital heart disease: a systematic review of the literature." International Journal of Behavioral Medicine. 25 (1 (Supplement)), p. S14.
Experiences of transgender prisoners and their knowledge, attitudes, and practices regarding sexual behaviors and HIV/STIs: a systematic review
Bromdal, Annette, Mullens, Amy B., Phillips, Tania M. and Gow, Jeff. 2019. "Experiences of transgender prisoners and their knowledge, attitudes, and practices regarding sexual behaviors and HIV/STIs: a systematic review." International Journal of Transgenderism. 20 (1), pp. 4-20. https://doi.org/10.1080/15532739.2018.1538838
Characteristics Of Early Adopters Of Hiv Point Of Care Testing (Poct) At Late-Night Sex On Premises Venue (Sopv) Theme Parties
Mullens, Amy, Daken, Kirstie, Lemoire, Jime, Brownlow, Charlotte and Gow, Jeff. 2018. "Characteristics Of Early Adopters Of Hiv Point Of Care Testing (Poct) At Late-Night Sex On Premises Venue (Sopv) Theme Parties." 15th International Congress of Behavioral Medicine. Santiago, Chile 14 - 17 Nov 2018 United States. Springer.
Integrating theories of alcohol consumption: how do drinking motives influence self-efficacy?
Girdlestone, D., Fein, E. and Mullens, A.. 2017. "Integrating theories of alcohol consumption: how do drinking motives influence self-efficacy?" 38th National Conference of the Australian Association for Cognitive and Behaviour Therapy (AACBT 2017):Innovations in Cognitive and Behavioural Therapies across the Lifespan. Sydney, Australia 26 - 28 Oct 2017 Australia.
Exploring HIV risks, testing and prevention among sub-Saharan African community members in Australia
Mullens, Amy B., Kelly, Jennifer, Debattista, Joseph, Phillips, Tania M., Gu, Zhihong and Siggins, Fungisai. 2018. "Exploring HIV risks, testing and prevention among sub-Saharan African community members in Australia." International Journal for Equity in Health. 17. https://doi.org/10.1186/s12939-018-0772-6
HIV risks and prevention: themes from a community forum among African community members in Queensland
Mullens, Amy, Debattista, Joseph, Gu, Zhihong, Siggins, Fungisai, Phillips, Tania and Kelly, Jennifer. 2017. "HIV risks and prevention: themes from a community forum among African community members in Queensland." ASBHM-CHP Conference 2017: Health and Health Behaviour Change - From Research to Practice and Back. Gold Coast, Australia 13 - 15 Jul 2017 Gold Coast, Australia.
Novel HIV testing during health promotion outreach: a qualitative analysis of field notes by peer-testers
Mullens, Amy, Duyker, Josh, Lemoire, Jime and Brownlow, Charlotte. 2017. "Novel HIV testing during health promotion outreach: a qualitative analysis of field notes by peer-testers." ASBHM-CHP Conference 2017: Health and Health Behaviour Change - From Research to Practice and Back. Gold Coast, Australia 13 - 15 Jul 2017 Gold Coast, Australia.
Health behaviours and health literacy: Hepatitis B regarding Sub-Saharan African migrants living in Queensland
Majerovic, A., Mullens, A., Debattista, J., Fein, E., Gu, Z. and Siggins, F.. 2017. "Health behaviours and health literacy: Hepatitis B regarding Sub-Saharan African migrants living in Queensland." ASBHM-CHP Conference 2017: Health and Health Behaviour Change - From Research to Practice and Back. Gold Coast, Australia 13 - 15 Jul 2017 Gold Coast, Australia.
Mentoring: results from the Australian Psychological Society College of Health Psychologists professional mentoring survey
Stapleton, P., Clarke, A., Strodl, E. and Mullens, A.. 2017. "Mentoring: results from the Australian Psychological Society College of Health Psychologists professional mentoring survey." ASBHM-CHP Conference 2017: Health and Health Behaviour Change - From Research to Practice and Back. Gold Coast, Australia 13 - 15 Jul 2017 Gold Coast, Australia.
Integrating theories of alcohol consumption: how do drinking motives influence HAPA self-efficacy?
Girdlestone, Denise, Fein, Erich and Mullens, Amy. 2017. "Integrating theories of alcohol consumption: how do drinking motives influence HAPA self-efficacy?" ASBHM-CHP Conference 2017: Health and Health Behaviour Change - From Research to Practice and Back. Gold Coast, Australia 13 - 15 Jul 2017 Gold Coast, Australia.
Lived experiences among transgender and gender diverse offenders and their knowledge, attitudes and practices regarding sexual behaviours and HIV/STIs, and knowledge and attitudes among prison officers towards transgender and gender diverse prisoners, sexuality and HIV/STIs: protocol for a systematic review
Bromdal, Annette, Mullens, Amy, Phillips, Tania and Gow, Jeff. 2017. "Lived experiences among transgender and gender diverse offenders and their knowledge, attitudes and practices regarding sexual behaviours and HIV/STIs, and knowledge and attitudes among prison officers towards transgender and gender diverse prisoners, sexuality and HIV/STIs: protocol for a systematic review." PROSPERO: International Prospective Register of Systematic Reviews. 18 Sept 2017.
Metacognitions mediate HIV stigma and depression/anxiety in men who have sex with men living with HIV
Strodl, Esben, Stewart, Lauren, Mullens, Amy B. and Deb, Sibnath. 2015. "Metacognitions mediate HIV stigma and depression/anxiety in men who have sex with men living with HIV." Health Psychology Open. 2 (1), pp. 1-11. https://doi.org/10.1177/2055102915581562
Guidelines for Peer Supervision
Mullens, Amy. 2016. "Guidelines for Peer Supervision." Drug Arm Clinical Worker State-wide professional development forum (2016). Annerley, Australia
Substance use among LGQBTIQ
Mullens, Amy. 2016. "Substance use among LGQBTIQ." College of Community Services (Drug Arm, Healthy Options) LGBT Symposium (2016). Brisbane, Australia 11 Feb 2016
Queensland Chemsex Study
Ray, Madeleine, Garvey, Shane, Mullens, Amy and Fein, Erich. 2017. "Queensland Chemsex Study." The 2017 Australian Winter School Conference. Brisbane, Australia 27 - 28 Jul 2017
PoCT (point of care) HIV/STI testing at after-hours SOPV (sex on premises venues) theme parties
Mullens, Amy, Driver, Glen, Lemoire, Jime and Daken, Kirstie. 2017. "PoCT (point of care) HIV/STI testing at after-hours SOPV (sex on premises venues) theme parties." 9th IAS conference on HIV science (IAS 2017). Paris, France 23 - 26 Jul 2017
Comparison of government and non-government alcohol and other drug (AOD) treatment service delivery for the lesbian, gay, bisexual, and transgender (LGBT) community
Mullens, Amy B., Fischer, Jane, Stewart, Mary, Kenny, Kathryn, Garvey, Shane and Debattista, Joseph. 2017. "Comparison of government and non-government alcohol and other drug (AOD) treatment service delivery for the lesbian, gay, bisexual, and transgender (LGBT) community." Substance Use and Misuse. 52 (8), pp. 1027-1038. https://doi.org/10.1080/10826084.2016.1271430
Predicating HIV risk behaviour secondary to substance use
Mullens, Amy, Young, Ross McD, Dunne, Michael P., Debattista, Joe and Norton, Graham. 2011. "Predicating HIV risk behaviour secondary to substance use." Australasian Professional Society on Alcohol and Other Drugs Conference 2011. Hobart, Tasmania 13 - 16 Nov 2011 United Kingdom.
Metacognitions mediate HIV stigma & depression/anxiety in men who have sex with men living with HIV
Mullens, Amy B., Strodl, Esben, Stewart, Lauren and Deb, Sibnath. 2016. "Metacognitions mediate HIV stigma & depression/anxiety in men who have sex with men living with HIV." 14th International Congress of Behavioral Medicine: Behavioral Medicine: Making an Impact in the Modern World (ICBM 2016). Melbourne, Australia 07 - 10 Dec 2016
Innovative methods to increase HIV testing among MSM in regional Queensland
Mullens, Amy, Duyker, Josh and Lemoire, Jime. 2016. "Innovative methods to increase HIV testing among MSM in regional Queensland." 14th International Congress of Behavioral Medicine: Behavioral Medicine: Making an Impact in the Modern World (ICBM 2016). Melbourne, Australia 07 - 10 Dec 2016
Depression mediates HIV stigma and medication adherence in men who have sex with men (living with HIV)
Mullens, Amy B., Strodl, Esben, Fein, Erich, Stewart, Lauren and Daken, Kirstie. 2016. "Depression mediates HIV stigma and medication adherence in men who have sex with men (living with HIV)." 14th International Congress of Behavioral Medicine: Behavioral Medicine: Making an Impact in the Modern World (ICBM 2016). Melbourne, Australia 07 - 10 Dec 2016
Utilisation of novel methodologies to engage 'hard to reach' clients in health promotion and screening, in rural and regional areas
Mullens, Amy B., Duyker, Josh and Lemoire, Jime. 2016. "Utilisation of novel methodologies to engage 'hard to reach' clients in health promotion and screening, in rural and regional areas." 8th Australian Rural and Remote Mental Health Symposium. Kingscliffe, Australia 02 - 04 Nov 2016 Nerang, Qld, Australia.
In search of critical pedagogy in sexuality education: visions, imaginations, and paradoxes
Sanjakdar, Fida, Allen, Louisa, Rasmussen, Mary Lou, Quinlivan, Kathleen, Bromdal, Annette and Aspin, Clive. 2015. "In search of critical pedagogy in sexuality education: visions, imaginations, and paradoxes." Review of Education, Pedagogy, and Cultural Studies. 37 (1), pp. 53-70. https://doi.org/10.1080/10714413.2015.988537
Supervision: considerations and self-reflective practice
Mullens, Amy. 2015. "Supervision: considerations and self-reflective practice." 2015 Queensland Clinical Training Network Research Symposium. Brisbane, Australia 12 - 13 Nov 2015 Australia.
A&D staff attitudes regarding LGBT clients
Mullens, Amy. 2016. "A&D staff attitudes regarding LGBT clients." 3rd International Conference on Social Identity and Health. Brisbane, Australia 16 - 18 Jun 2016 St Lucia, Australia.
Intersex bodies in sexuality education: on the edge of cultural difference
Bromdal, Annette, Rasmussen, Mary Lou, Sanjakdar, Fida, Allen, Louisa and Quinlivan, Kathleen. 2017. "Intersex bodies in sexuality education: on the edge of cultural difference." Allen, Louisa and Rasmussen, Mary Lou (ed.) The Palgrave handbook of sexuality education. London, United Kingdom. Palgrave Macmillan. pp. 369-390
Substance-related expectancies among men who have sex with men: development of psychometric tools to predict unprotected sexual activity
Boedicker Mullens, Amy. 2011. Substance-related expectancies among men who have sex with men: development of psychometric tools to predict unprotected sexual activity. PhD Thesis Doctor of Philosophy. Queensland University of Technology.
Sexuality education in public schools in Australia and Aotearoa - New Zealand
Rasmussen, Mary Lou, Sanjakdar, Fida, Quinlivan, Kathleen, Allen, Louisa, Bromdal, Annette and Aspin, Clive. 2016. "Sexuality education in public schools in Australia and Aotearoa - New Zealand." Rasmussen, Mary Lou (ed.) Progressive sexuality education: the conceits of secularism. New York. Routledge. pp. 48-70
Who's afraid of sex at school? The politics of researching culture, religion and sexuality at school
Allen, Louisa, Rasmussen, Mary Lou, Quinlivan, Kathleen, Aspin, Clive, Sanjakdar, Fida and Bromdal, Annette. 2012. "Who's afraid of sex at school? The politics of researching culture, religion and sexuality at school." International Journal of Research and Method in Education. 37 (1), pp. 31-43. https://doi.org/10.1080/1743727X.2012.754006
Confidant and breast cancer patient reports of quality of life
Sandgren, Ann K., Mullens, Amy B., Erickson, Shannon C., Romanek, Kathleen M. and McCaul, Kevin D.. 2004. "Confidant and breast cancer patient reports of quality of life." Quality of Life Research. 13 (1), pp. 155-160. https://doi.org/10.1023/B:QURE.0000015287.90952.95
The amyl nitrite expectancy questionnaire for men who have sex with men (AEQ-MSM): a measure of substance related beliefs
Mullens, Amy B., Young, Ross, Dunne, Michael P. and Norton, Graham. 2011. "The amyl nitrite expectancy questionnaire for men who have sex with men (AEQ-MSM): a measure of substance related beliefs." Substance Use and Misuse. 46 (13), pp. 1642-1650. https://doi.org/10.3109/10826084.2011.599096
The drinking expectancy questionnaire for men who have sex with men (DEQ-MSM): a measure of substance-related beliefs
Mullens, Amy B., Young, Ross McD., Dunne, Michael P. and Norton, Graham. 2011. "The drinking expectancy questionnaire for men who have sex with men (DEQ-MSM): a measure of substance-related beliefs." Drug and Alcohol Review. 30 (4), pp. 372-380. https://doi.org/10.1111/j.1465-3362.2010.00225.x
The cannabis expectancy questionnaire for men who have sex with men (CEQ-MSM): a measure of substance-related beliefs
Mullens, A. B., Young, R. McD., Dunne, M. and Norton, G.. 2010. "The cannabis expectancy questionnaire for men who have sex with men (CEQ-MSM): a measure of substance-related beliefs." Addictive Behaviors. 35, pp. 616-619. https://doi.org/10.1016/j.addbeh.2010.01.006
The consequences of substance use among gay and bisexual men: a consensual qualitative research analysis
Mullens, Amy B., Young, Ross McD., Hamernik, Elisabeth and Dunne, Michael. 2009. "The consequences of substance use among gay and bisexual men: a consensual qualitative research analysis." Sexual Health. 6 (2), pp. 139-152. https://doi.org/10.1071/SH08061
Sex on premises venue (SOPV) health promotion project in response to sustained increases in new HIV notifications
Mullens, Amy B., Staunton, Shaun, Debattista, Joseph, Hamernik, Elisabeth and Gill, Darren. 2009. "Sex on premises venue (SOPV) health promotion project in response to sustained increases in new HIV notifications." Sexual Health. 6 (1), pp. 41-44. https://doi.org/10.1071/SH07087
The motivational effects of thinking and worrying about the effects of smoking cigarettes
McCaul, Kevin D., Mullens, Amy, Romanek, Kathleen M., Erickson, Shannon C. and Gatheridge, Brian J.. 2007. "The motivational effects of thinking and worrying about the effects of smoking cigarettes." Cognition and Emotion. 21 (8), pp. 1780-1798. https://doi.org/10.1080/02699930701442840
Meeting at the crossroads: re-conceptualising difference in research teams
Allen, Louisa, Quinlivan, Kathleen, Aspin, Clive, Sanjakdar, Fida, Bromdal, Annette and Rasmussen, Mary Lou. 2014. "Meeting at the crossroads: re-conceptualising difference in research teams." Qualitative Research Journal. 14 (2), pp. 119-133. https://doi.org/10.1108/QRJ-08-2013-0047
Sexuality Education in Public Schools in Australia and Aotearoa New Zeeland
Rasmussen, Mary Lou, Sanjakdar, Fida, Quinlivan, Kathleen, Allen, Louisa, Bromdal, Annette and Aspin, Clive. 2016. "Sexuality Education in Public Schools in Australia and Aotearoa New Zeeland ." Rasmussen, Mary Lou (ed.) Progressive Sexuality Education: The Conceits of Secularism. New York. Routledge. pp. 48-70
Coping after cancer: risk perceptions, worry and health behaviors among colorectal cancer survivors
Mullens, Amy B., McCaul, Kevin D., Erickson, Shannon C. and Sandgren, Ann K.. 2004. "Coping after cancer: risk perceptions, worry and health behaviors among colorectal cancer survivors." Psycho-Oncology: journal of the psychological, social and behavioral dimensions of cancer. 13 (6), pp. 367-376. https://doi.org/10.1002/pon.751