Background

The rate of obesity is similar between transgender and cisgender patients. There is limited research on transgender bariatric patients. The aim of this study is to discuss the variables that may impact these patients including long-term weight loss and special psychological considerations.

Methods

A retrospective chart review was conducted of adult transgender patients who underwent minimally invasive bariatric procedure between 2018-2021, with 2 year follow-up data available. Patients were identified for BMI > 35 using our institution's database. Different variables were studied among trans-male and trans-female patients including excess body weight loss(EBWL), cross sex hormone therapy, perioperative chemical venous thromboembolism(VTE) prophylaxis, and psychosocial assessment.

Results

A total of 5 patients met inclusion criteria; 3 trans-female patients and 2 trans-male patients. All patients underwent and fulfilled presurgical psychological evaluation. Three patients underwent gastric bypass and two patients underwent sleeve gastrectomy. Average EBWL among trans-female patients was 52.2%, whereas average EBWL among trans-male patients was 51.8%. Average EBWL among sleeve patients was 49.2%, whereas average EBWL among bypass patients was 53.9%. All patients were maintained on their cross sex hormones throughout the perioperative period. All patients received VTE prophylaxis during perioperative period but were not on extended VTE prophylaxis. No patient experienced a postoperative VTE.

Conclusions

Review of transgender patients who underwent bariatric surgery at our institution demonstrate that they have similar EBWL compared to our cisgender patients at 2 years postoperatively. Further investigation is warranted to determine additional psychological or sex hormone's effect on weight loss success of transgender patients.