The Psychological Impact of Gender-Affirming Surgeries: A Comparative Study of Transgender Individuals with and without Surgical Access

This systematic review investigates the psychological impact of gender-affirming surgeries (GAS) on transgender individuals, focusing on mental health outcomes, access to care, and systemic barriers. Transgender people, whose gender identity differs from the sex assigned at birth, have been part of diverse cultures across history. From the hijras of ancient and medieval India to gender-diverse shamans in indigenous tribes worldwide, trans people have long held spiritual, social, and cultural significance Drawing from global data, including qualitative and quantitative studies, the review highlights evidence that GAS significantly improves psychological well-being, reduces distress, and enhances quality of life. However, access remains hindered by discrimination, gatekeeping, and financial constraints. Recommendations include improving affirming care, eliminating institutional barriers, and recognizing GAS as medically necessary.