Understanding the Market for Gender Confirmation Surgery in the Adult Transgender Community in the United States: Evolution of Treatment, Market Potential, and Unique Patient Characteristics

Abstract

Purpose: Estimate the size of the market for gender confirmation surgery and identify regions of the United States where the transgender population is underserved by surgical providers. Additionally, inform new surgeons who seek to contribute to gender transformation about the unique patient characteristics of the transgender population. Methods: To estimate the size of the gender confirmation surgery market, we used the best available data in LGBTQ surveys and literature to estimate the prevalence of transgender people in the United States, the demand for various types of gender confirmation procedures, and a range of prices for two major groups of procedures, “top-surgery” and “bottom-surgery.” Regional saturation of surgeons who advertise gender confirmation procedures was triangulated from the aforementioned estimates as well as provider supply estimates from an online aggregator of surgeons who advertise transgender surgical services. Results: The market size for top- and bottom-surgery is between $11 and $20 billion dollars, with top-surgery representing $2 to $5 billion and bottom-surgery $9 to $15 billion. The Midwest boasts the largest absolute market for all surgeries at about 240,000 patients as well as the lowest average providers per available patient (2.00 per 10,000). Nationally, bottom-surgery in both male-to-female and female-to-male patients are the least developed markets for transgender surgery with provider saturation of 1.06 and 1.18 providers per 10,000 patients, respectively. Conclusions: The Midwest region in the United States is likely the most underserved gender confirmation surgery market with the largest available patient pool and lowest surgeon saturation rate. New providers in the gender confirmation surgery market should have an appreciation for the financial and social barriers that transgender people face in achieving surgical transition.