Bibliometric Analysis of the 100 Most Cited Publications in Gender Affirming Surgery

Background Gender-affirming surgeries serve as a fundamental treatment for gender dysphoria, with growing evidence of their benefits in both health outcomes and quality of life. Objectives To identify and analyze the 100 most-cited articles in the field, to highlight impactful studies, research trends, and prominent authors. Methods A search of the Web of Science (WoS) database was conducted to identify the top 100 most-cited articles related to gender-affirming surgery. Bibliometric and visual analyses were performed using VOSviewer, Bibliometrix, and Biblioshiny packages for R statistical software. We gathered and analyzed citation metrics, institutional networks, collaboration clusters, thematic keyword analysis, and author demographics. Results The 100 most-cited articles on gender-affirming surgery were published between 1980 and 2023, with an increase in both publication and citations after 2015. The thematic analysis demonstrated two primary research domains which focused on patient quality of life and surgical outcomes. The research institutions Vrije Universiteit Amsterdam, Johns Hopkins and Ghent University led the field with Bouman and Mullender being among the most productive authors. The USA, together with the Netherlands emerged as dominant research centers with collaborative networks. Most studies were observational and reviews, with a mean evidence level of 3.05 and published primarily in Journal of Sexual Medicine and Plastic and Reconstructive Surgery. Conclusions This first analysis of the 100 most-cited articles in the field of gender-affirming surgery highlights prominent authors, trends in research themes, and dominant geographic regions. Continued comprehensive bibliometric reviews are a necessity to guide future research and clinical practice.