Top surgery enhances body satisfaction and quality of life in transgender men: results from a cross-sectional study using a transgender-specific questionnaire
DOI:
https://doi.org/10.2340/jphs.v60.43490Keywords:
Gender affirming surgery, top surgery, gender affirming mastectomy, transgender man, SF-36, ETLI, BODY-Q ChestAbstract
Background: This is the first exploratory investigation of the Essen Transidentity Quality of Life Inventory (ETLI) questionnaire administered to transgender men before and after mastectomy.
Methods: Eighty-two transgender men were enrolled in a cross-sectional study. Depending on whether a mastectomy had been performed, 42 patients were assigned to the preoperative and 40 to the postoperative group. Data collection included epidemiologic data, screening questions for comorbidities or mental disorders and three questionnaires (Short-Form Health Survey [SF-36], BODY-Q Chest Module and ETLI). The trial was registered at the German Clinical Trial Register under the number: DRKS00035156. Qualitative data were compared using the chi-squared test, and quantitative scores were analysed using the t-test. Effect sizes were determined using ANOVA. A p-value < 0.05 was considered significant.
Results: The average age of the participants was 26.9 years, with an average duration of hormone intake of 31.4 months and a BMI of 23.8 kg/m². The subscales mental quality of life (QoL) (p < 0.001), physical QoL (p < 0.001), social QoL (p < 0.001) and the global sum score (p < 0.001) of the ETLI showed significantly different scores in the postoperative group compared to the preoperative group. Similarly, the mental component scale of the SF-36 (<0.001) and the Body-Q Chest Module ‘chest’ (< 0.001) and ‘nipples’ (< 0.001) were significantly increased in the group after mastectomy.
Conclusion: The ETLI questionnaire is a viable tool to measure effects on the QoL and satisfaction with body image in transgender men, correlating with well-established scores.
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Copyright (c) 2025 Torsten Schulz, Johanna Grünewald, Stefania Sima, Yasmin Molter, Kristin Lidzba, Günce Ciklatekerlio, Stefan Langer, Rima Nuwayhid

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