Body Image in Transmen: Multidimensional Measurement and the Effects of Mastectomy.
BACKGROUND
Transmen are generally dissatisfied with their breasts and often opt for mastectomy. However, little is known about the specific effects of this procedure on this group's body image.


OBJECTIVE
To prospectively assess the effect of mastectomy on the body image of transmen, including cognitive, emotional, and behavioral aspects.


METHODS
During a 10-month period, all transmen applying for mastectomy were invited to participate in this study. The 33 participants completed assessments preoperatively and at least 6 months postoperatively.


METHODS
Participants were surveyed on body satisfaction (Body Image Scale for Transsexuals), body attitudes (Multidimensional Body-Self Relations Questionnaire), appearance schemas (Appearance Schemas Inventory), situational bodily feelings (Situational Inventory of Body Image Dysphoria), body image-related quality of life (Body Image Quality of Life Inventory), and self-esteem (Rosenberg Self-Esteem Scale). Control values were retrieved from the literature and a college sample.


RESULTS
Before surgery, transmen reported less positive body attitudes and satisfaction, a lower self-esteem and body image-related quality of life compared with cisgender men and women. Mastectomy improved body satisfaction most strongly, although respondents reported improvements in all domains (eg, decreased dysphoria when looking in the mirror and improved feelings of self-worth). Most outcome measurements were strongly correlated.


CONCLUSIONS
Mastectomy improves body image beyond satisfaction with chest appearance alone. Body satisfaction and feelings of "passing" in social situations are associated with a higher quality of life and self-esteem.
Department of Medical Psychology, Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Tim C
TC
van de Grift
Department of Medical Psychology, Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands.
Baudewijntje P C
BP
Kreukels
Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Lian
L
Elfering
Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Müjde
M
Özer
Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Mark-Bram
MB
Bouman
Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Marlon E
ME
Buncamper
Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Jan Maerten
JM
Smit
Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: m.mullender@vumc.nl.
Margriet G
MG
Mullender
D000328:Adult; D001294:Attitude to Health; D057215:Body Dysmorphic Disorders / Q000523:psychology; D001828:Body Image; D003865:Major Depressive Disorder; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008408:Mastectomy / Q000523:psychology; D008875:Middle Aged; D010549:Personal Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012649:Self Concept; D011795:Surveys and Questionnaires; D063106:Transgender Persons / Q000523:psychology*; D014189:Transsexualism / Q000523:psychology* / Q000601:surgery
Body Image; Chest Wall Masculinizing Surgery; Gender Dysphoria; Mastectomy; Self-Esteem; Transgender