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Purpose: Gender affirmation surgery (GAS) refers to surgical procedures that align physical appearance with gender identity. Data are limited regarding GAS in national cohort studies and we aimed to assess GAS in Danish transgender persons.

Methods: We conducted a national register-based cohort study in Danish transgender persons. Persons with International Classification of Diseases (ICD)-10 diagnosis code of “gender identity disorder” were included during 2000–2021 and surgical procedure codes were identified up to and including June 2022.

Results: The cohort included 3812 transgender persons with median age (interquartile range) at study inclusion 19.0 (15.0; 24.0) years for persons assigned female sex at birth (AFAB, N=1993) and 23.0 (19.0; 33.0) years for persons assigned male sex at birth (AMAB, N=1819). The mean (standard deviation) follow-up duration was 4.5 (4.3) years. In persons …