The team identified 37,827 hospital encounters in the national database that had ICD-9 diagnosis codes of transsexualism or gender identity disorder that were listed in the National Inpatient Sample. The rate of those codes increased from 3.87/100,000 patients in 2000 to 14.22 /100,000 patients in 2014.
Mental health was the leading cause of hospitalization, accounting for 40.5% of admissions, a finding that “is consistent with the high prevalence of depression, anxiety, and suicidal ideation in this population,” the investigators said.
Patients were a median age of 38 years old; 57.1% identified as white; and 54.3% were categorized as male, 38.3% as female, and most of the rest as “inconsistent,” meaning their sex in the medical record did not match their procedures.
Almost 11% were hospitalized for gender affirmation surgery, including penile or vaginal construction. From 2000 to 2005, 72% of patients who underwent affirmation procedures had genital surgery; the number increased to 83.9% from 2006 to 2011. More than half of the patients weren’t covered by insurance, but the number covered by Medicare or Medicaid increased from 25 patients in 2012-2013 to 70 in 2014. Meanwhile, no one died in the hospital from gender reassignment surgery, and the median stay was 4 days.