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Background: Medicare reimbursement rates are essential knowledge for gender-affirming plastic surgeons. The goal of this project was to examine trends in Medicare reimbursement rates for gender-affirming plastic surgery procedures from 2007 to 2020., Methods: Changes in reimbursement rates were measured for 35 commonly used gender-affirming procedure CPT codes from 2007 to 2020 adjusted for inflation to the 2020 US dollar value. The Unadjusted Percent Change in Consumer Price Index (CPI) was calculated using data from the US Bureau of Labor Statistics. Reimbursement rates were adjusted for inflation using the CPI for each year. Student t test was utilized for mean comparisons., Results: Mean percent change in reimbursement rates was +16.01% while the percent change in CPI was +27.45%. Comparison between rate change of inflation versus rate change in adjusted medical reimbursement was significantly higher in the inflation group (P < 0.0001). Inflation adjustments for the Compound Annual Growth Rate was negative (-0.76%). The adjusted total percent change was also calculated at an average of -8.97%., Conclusions: This is the first study evaluating trends in Medicare reimbursement rates for commonly selected gender-affirming procedures in the United States. After adjusting for inflation, Medicare reimbursement rates for all gender-affirming surgeries analyzed declined from the years 2007 to 2020 compared to expected inflation base. Increased consideration of these trends will be important for US policymakers, hospitals, and surgeons to ensure ease of access to gender-affirming care for transgender individuals., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: Gender-affirming bottom surgeries (GABS) play a central role in treating gender dysphoria to improve quality of life for transgender and nonbinary (TGNB) patients. However, there exists limited data on operative risks and outcomes for patient populations undergoing GABS. The goal of this study is to identify sociodemographic and clinical risk factors for determining 30-day postoperative complications in patients undergoing GABS., Methods: The ACS-NSQIP database from 2010 to 2020 was used to identify patients undergoing gender affirmation surgery (GAS) using Current Procedural Terminology (CPT) codes included in transfeminine and transmasculine bottom surgery. IBS-SPSS software was used to perform a multivariate analysis to determine risk factors for increased 30-day postoperative complications including unplanned reoperation and readmission rates., Results: A total of 1809 GABS were performed in the NSQIP database from 2010 to 2020. There was an upward trend in GABS procedures throughout the years, with 2017 having the most GABS (n = 629). Transmasculine patients with a BMI of 29 and over were at a greater risk for wound complications (P < 0.05). Diabetic transfeminine patients were also at a greater risk for wound complications (P < 0.05)., Conclusions: This study identified that several sociodemographic and clinical risk factors, such as BMI and diabetes mellitus type 2, had increased postoperative complications for patients undergoing gender-affirming bottom surgeries. Wound care management and patient education are essential in GABS to prevent long-term complications. Physician awareness of risk factors and social determinants of health can help prevent and improve postoperative care education and patient compliance., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)