Exploring gender-affirming care from a surgeon's perspective

Marci Bowers, MD, discusses how her practice has evolved over time and shares valuable insights on the steps toward gender-affirming surgery.

Transcript

00:00

It's really very clear that gender identity is established at a very early age. And that becomes largely immutable.

00:08

[MUSIC PLAYING] I'm Marci Bowers. I am a gynecologic and pelvic reconstructive

00:16

surgeon specializing in gender-affirming surgeries.

00:24

Lots of things have evolved over the years. In my practice, we're seeing increasingly younger and younger patients.

00:31

Puberty can actually be blocked by giving one of the puberty agonist hormones that normally is released from the hypothalamus of the brain.

00:40

What is fortunate about these puberty-delaying treatments is is they-- they don't definitively answer the question.

00:49

They allow time to process and make sure that the feelings of gender dysphoria and the desire

00:57

to change your sex anatomically, those things persist so that, when a decision is finally made,

01:07

it can, with greater assurance, be the right decision.

01:16

The biggest question is, what level of distress is this causing? When you're coming to me as a surgeon,

01:22

I'm at the end of the line, so to speak. And usually by then, patients have been living in their desired gender.

01:28

And they are probably on hormones, or they're supposed to be at least, according to the standards of care. And so those are the two-- the two questions