Key Findings

• 39 studies included in the review
• Evidence ranged from high to very low certainty
• High-certainty evidence only for physical complications (death, necrosis, scarring)
• Psychological outcomes lack high-quality evidence
• Case series provided most of the high-certainty evidence
• Prospective cohort studies needed

Abstract

Systematic review and meta-analysis of 39 studies evaluating mastectomy for individuals with gender dysphoria under 26 years. Evidence ranged from high to very low certainty.

Summary

This SEGM-funded review found that the evidence for mastectomy in gender-dysphoric youth is weak, with high-certainty evidence only for physical complications. Psychological outcome evidence is very low quality.

Conclusion

The evidence base for mastectomy in youth with gender dysphoria is weak, with only physical complications having high-certainty evidence. High-quality prospective studies are needed.