When Daniel Sasson, a fourth-year medical student, was completing his undergraduate studies at Emory University in Atlanta, he volunteered his nights on an anonymous student-run hotline. He helped students who called in, many of whom he recalls were struggling with their gender and sexuality. When he came to Feinberg, Sasson was invited by a current resident who knew of his background in working with adolescents in gender and sexuality to collaborate on a study exploring top surgery and chest dysphoria in transgender and non-binary adolescents.
The study, recently published in JAMA Pediatrics, found that three months after receiving top surgery, patients demonstrated improved perceptions of chest dysphoria, gender congruence and body image. Sasson presented his team’s findings at the U.S. Professional Association for Transgender Health’s (USPATH) virtual scientific symposium last November.
Read a Q&A with Sasson below.
Why did you choose Feinberg?
Listen to Sasson below:
So, there are really two components which convinced me that Feinberg was the right place to start my career in medicine. The first was the current students I had met during my interview day and Second Look. There’s an understanding that Northwestern students are not only among the most hardworking and scientific, but also strongly empathetic, compassionate and sociable. Second component, which strongly drew me to Feinberg, was their dedication to research. I always knew I wanted to dedicate a significant portion of my career to research, and I’m glad I correctly chose Feinberg as the place to nurture and encourage this interest.
What are your plans for after medical school?
Regardless of what area of medicine I enter, I’d still like to have a significant role in transgender health and trying to lay out the guidelines for gender affirmation treatment, whether that’s from the surgical side of things or from the psychiatry side of things. I would like to play a significant role in trying to empower and encourage the patients who need this care to be able to obtain it.
Tell me more about your paper. What were your findings?
We were trying to determine the efficacy of mastectomy for transgender men and non-binary individuals observed female at birth. There is some literature for adults as to whether top surgery can help with feelings of gender dysphoria, chest dysphoria and overall body image, but there really isn’t that much data on adolescents and younger adults. So, we felt that this study was uniquely positioned to help young individuals in that position.
For our study, we recruited patients between 2019 and 2021 who were between the ages of 13 and 24. We had two groups: one was patients who desired top surgery and presenting to a plastic surgery clinic for consultation, and the second was patients currently enrolled in Lurie Children’s Gender Development Program; this second group represented our control. We administered a series of validated surveys to both groups. Then three months after the surgical group received their surgery, we administered the surveys again to see how their overall levels of gender dysphoria, chest dysphoria, gender congruence, and body image changed.
Overall, we had 81 patients that were enrolled and what we found was that there was a large association between patients receiving surgery and improvements in their chest dysphoria, gender congruence, and body image. This was the first study in this particular age group to demonstrate these benefits stemming from top surgery.
How can your findings contribute to today’s climate regarding healthcare for transgender and non-binary individuals?
It’s no secret that currently in the U.S. and around the world the environment towards trans and non-binary individuals could be friendlier, and that we can be doing more to help these individuals both at the government level and as citizens. This study has the opportunity to demonstrate that this procedure and the treatment medical providers are giving is something that’s actually effective for these patients.
As far as future steps go, we published our findings at three months, but we are also collecting a one-year data point. We’re hoping that once we synthesize the final data, we’ll be able to show more definitively that these changes are long-lasting.
What advice would you give to current medical students?
I would say to trust the process. Feinberg is respected as a school and our medical students are taken seriously when they apply to residency because programs know the product they’re getting; it’s a product that’s carefully crafted to be empathetic, smart, and a well-rounded physician. I think that there’s a strong desire for a lot of students, often in the beginning of medical school, to focus closely on just the science while not paying the necessary respect to other humanistic components of our medical education. Feinberg is among the best for a reason!