Mental Health, Gender Dysphoria, and Quality of Life in Trans Individuals Following Top Surgery: A Prospective Cohort Study Protocol (Preprint)

BACKGROUND Top surgery refers to various gender-affirming surgical procedures involving breast or chest tissue. Existing research suggests top surgery improves physical, psychological, and social well-being in trans individuals who desire it. However, most studies have been retrospective, have not used validated outcome measures, and excluded non-binary individuals, limiting the robustness of the existing research. OBJECTIVE This study aims to longitudinally examine the impact of top surgery on mental health, gender dysphoria, and quality of life of trans people, including both binary and non-binary individuals. METHODS Trans individuals aged 16 and older undergoing top surgery will be recruited from a single surgeon’s office in Perth, Western Australia, as part of a longitudinal prospective cohort study. Questionnaires will be administered to participants at three timepoints: 6–8 weeks pre-surgery, 6–8 weeks post-surgery, and 1-year post-surgery. Patient-reported outcomes will be measured using validated instruments and bespoke items developed through community consultation. Surgical satisfaction will be assessed using both patient- and surgeon-reported measures, enabling between-group comparisons. RESULTS Quantitative data will be analyzed using linear regression models and repeated measures ANOVA; qualitative data will undergo reflexive thematic analysis. CONCLUSIONS This study will extend current research on the mental health, gender dysphoria, and quality of life outcomes of top surgery for trans individuals. By incorporating a longitudinal design, validated measures, and inclusion of non-binary participants, this research aims to improve the understanding of trans people’s experience of accessing and receiving top surgery.