Neuroradiology in Transgender Care: Facial Feminization, Laryngeal Surgery, and Beyond
- 1 January 2022
- journal article
- research article
- Published by Radiological Society of North America (RSNA) in RadioGraphics
- Vol. 42 (1), 233-249
- https://doi.org/10.1148/rg.210080
Abstract
Transgender individuals experience incongruence between their gender identity and the sex assigned to them at birth. This incongruence can cause many transgender individuals to experience distressing physical and mental discord, a diagnosis known as gender dysphoria. Craniofacial structures have distinct anthropometric characteristics that affect perceived masculinity and femininity. The face, neck, and voice are highly exposed anatomic areas that have recognizable gender-specific characteristics that may hinder a transgender individual's successful social integration and public acceptance. Reconstructive facial and laryngeal procedures are among the surgical options transgender persons may elect to undergo to better align their physical appearance with their gender identity. These include feminization surgeries such as facial feminization and reduction chondrolaryngoplasty, as well as masculinizing facial and laryngeal surgeries. Maxillofacial CT is frequently used in the preoperative evaluation of patients before facial feminization surgery (FFS). Several CT measurements guide surgeons to the optimal correction required in FFS to achieve appropriate aesthetic planes. Mapping important craniofacial landmarks to avoid untoward surgical complications is crucial. Transgender patients may encounter other neurologic complications that require neuroimaging evaluation. For example, gender-affirming hormone therapy (eg, estrogen and testosterone) may increase the risk of stroke or may influence growth of various hormone-sensitive tumors such as pituitary adenomas. Radiologists may interpret imaging examinations in transgender patients for routine care or for evaluation before and after facial and laryngeal surgeries and must be aware of the role of neuroimaging in the care of this population. An invited commentary by Callen is available online. The online slide presentation from the RSNA Annual Meeting is available for this article. ©RSNA, 2022 Download as PowerPointKeywords
This publication has 60 references indexed in Scilit:
- Symptomatic meningioma induced by cross-sex hormone treatment in a male-to-female transsexualEndocrinología y Nutrición, 2013
- Long-Term Evaluation of Cross-Sex Hormone Treatment in Transsexual PersonsThe Journal of Sexual Medicine, 2012
- A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormonesActa Endocrinologica, 2011
- Development of a symptomatic intracranial meningioma in a male-to-female transsexual after initiation of hormone therapyJournal of Clinical Neuroscience, 2010
- Facial determinants of female gender and feminizing forehead cranioplastyThe Laryngoscope, 2010
- Regression of meningiomas after discontinuation of cyproterone acetate in a transsexual patientActa Neurochirurgica, 2010
- Effects of Intramuscular Testosterone Undecanoate on Body Composition and Bone Mineral Density in Female-to-Male TranssexualsThe Journal of Sexual Medicine, 2010
- Effect of sex steroid use on cardiovascular risk in transsexual individuals: a systematic review and meta‐analysesClinical Endocrinology, 2009
- Regional gray matter variation in male-to-female transsexualismNeuroImage, 2009
- Challenges in Care of the Transgender Patient Seeking Facial Feminization SurgeryFacial Plastic Surgery Clinics of North America, 2008