Gender-Affirming Surgery Crowdfunding
Ronald K. Akiki, BA1, Daniel Kwan, MD2.
1The Warren Alpert Medical School of Brown University, Providence, RI, USA, 2Department of Plastic and Reconstructive Surgery, Rhode Island Hospital, Providence, RI, USA.
BACKGROUND: According to the 2015 U.S. Transgender Survey, 55% of patients undergoing gender-affirming surgery reported difficulty in obtaining health insurance coverage. Gender-affirming surgery places a high financial burden on transgender patients, especially those lacking coverage. Online medical crowdfunding has grown significantly over the last decade. Patients are able to create public campaigns on social media to advertise their fundraisers to potential donors. For transgender patients, the money collected may be used to pay for their surgery or hormonal therapy. In this study, we updated the geographic trends in fundraising for gender-affirming surgery and sought to establish the factors influencing the amount raised per campaign.
METHODS: Campaigns were identified from GoFundMe with the search term “Transgender surgery”. Data collected included title, description, amount raised and goal, number of shares and donors, and location. Pearson’s correlation and one-way ANOVA were used for statistical analyses.
RESULTS: 1010 crowdfunding campaigns were identified with 42,819 donors and a total of $2,890,807 raised for an average of 40.1 donors and $3,120 ± 213 raised per campaign. Looking at the different regions of the country, there was a statistically significant difference in number of campaigns adjusted for population size among the four subregions of the US (p<0.0001). Notably, the West had the highest proportion of campaigns (n= 242, 34.6%). We found similar results at the state level (p<0.0001). Notably, Vermont followed by Washington then Oregon had the highest number of campaigns after adjusting for population size (14%, 5.3%, and 4.2%, respectively). Controlling for each variable, we found that campaigns that raised the greatest amount of funds were associated with longer descriptions (p<0.0001, r=0.34), higher number of social media shares (p<0.0001, r=0.39), higher goal amount (p=0.041, r=0.19), and number of donors (p<0.0001, r=0.44). The most common words used in the most successful 25% of campaigns were “insurance,” “hard,” “pay,” “dysphoria” (negative sentiments), and “love,” “support,” “help,” “life” (positive sentiments). CONCLUSIONS: Our data suggest that patients in the West subregion seem to have the highest need for funding, as identified by the highest adjusted number of campaigns. Social media and number of donors may be the two most important factors for patients to reach their goal amount. Plastic surgeons will likely encounter medical crowdfunding with increased frequency as it continues to grow in popularity among their transgender patients. Increased awareness among surgeons may allow further discussion about the feasibility of raising funds online with their patients.
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