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Elective Surgery for HIV+ Patients

Mar 10, 1997

I am a pre-operative transsexual(male-to-female). I was approved for and had scheduled gender reassignment surgery prior to an HIV+ diagnosis. I am asymptomatic with high (>600) CD-4 counts and undectable viral load. I have considered the possibility of proceeding with the gender surgery (vaginoplasty + breast augmentation). My own physician, though cautious, has agreed to write a recommendation favoring this surgery, arguing that the benefits to me personally (and note, these are NOT sexual benefits!) outweigh the risk factors. In general would you concur that an elective surgery of this type is a reasonable proceedure to consider? Your opinion on the wisdon of this route would be most appreciated.

Response from Dr. Cohen

If you are asymptomatic with a high CD4 count, then from your own point of view, your HIV status doesn't really enter into the decision very much. There is no evidence that your HIV infection would have any effect on the outcome of surgery, or vice versa. You should do what you and your doctor feel to be in your best interest.

Some surgeons may feel differently, however, and may be unwilling to proceed with the surgery because you are HIV positive. Since it is "elective" they have that perogative, and you may have to look around for a surgeon who is willing to operate on you.

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