Preference of FTM Transgenders for Partial Gender Affirming Surgery: Does the Answer Lie in Improved Quality of Life and Bodily Satisfaction with Masculinising Top Surgery? A Descriptive Survey Study

Background: For individuals with gender dysphoria, discomfort with their biological sex characteristics often leads to broader body image concerns. Masculinising top surgery, a popular gender affirming surgery, modifies an individual’s body to align with gender identity and expression by alleviating social, physical and psychological problems. The aim of our study is to assess patient satisfaction and quality of life (QOL) after top surgery and explore reasons for partial treatment request. Methods: In this prospective survey study of 10 female-to-male (FTM) transgenders who underwent top surgery, the questionnaires developed using validated survey tools such as Breast Questionnaires (BREAST-Q) and the Body Uneasiness Test-A (BUT-A) were distributed to the respondents one week before and six months post-surgery. The information on treatment requests and the motives behind the partial treatment requests was explored. Results: Ten patients (mean age 24.4 years) underwent top surgery as their initial gender affirming procedure. At six months, BREAST-Q scores improved significantly, with comfort in clothing increasing from 0.5 to 3.6 and comfort during sexual activity from 0.4 to 3.2, while self-confidence rose from 0.5 to 2.9. BUT-A scores showed marked reductions in body image concerns (4.3–0.2) and body dissatisfaction (3.8–0.3). Postoperatively, 60% opted for partial treatment due to improved QOL and sexual well-being. Conclusion: With the growing recognition and acceptance of transsexuality, there is an urgent need for a validated instrument to assess patients’ bodily satisfaction and QOL after masculinising top surgery. The partial treatment request and the underlying motive being improved QOL and sexual well-being further strengthens the role of top surgery.