Mental health impacts of weight-based denial from gender-affirming surgery: A case report

Introduction: High body mass index (BMI) can be a barrier to accessing gender-affirming surgery (GAS). Method: This case report discusses the mental health implications of being denied GAS based on BMI in a transgender woman presenting to psychiatric care integrated with primary care. Subsequently, we summarize existing literature regarding GAS and mental health. Result: Existing literature on GAS outcomes robustly demonstrates the mental health benefits of undergoing desired GAS and does not support using BMI to determine surgical candidacy. Conclusion: This case highlights why psychiatrists and other mental health clinicians should be concerned about BMI serving as a barrier to our patients accessing GAS.