His Surgeries Change Lives for Transgender Patients
One in an ongoing series.
Jared Liebman, MD, can best describe the impact of his work with an anecdote.
A patient transitioning from female to male came to see him about having breast reduction surgery. The patient’s breasts were flattened with fabric binder to reduce their prominence; he sat with shoulders hunched to further reduce their visibility. His mood was dark. He sought – and received – surgery, to have his breast tissue removed.
When Dr. Liebman walked into the examining room for a post-operative visit, the contrast was dramatic. The patient sat on the examining table, leaning back, his hands behind his head, proudly displaying his bare, now flat, chest.
He no longer had anything to hide, no evidence that he and his body were at odds. “His posture spoke very loudly of his new sense of self,” Dr. Liebman said.
Dr. Liebman is a plastic surgeon with Einstein Healthcare Network who performs “top surgery” – breast augmentation or reduction – for patients whose gender identity is not congruent with the sex they were assigned at birth. He has performed more than 300 gender transition procedures over the last two years.
Although it may seem to persons outside the LGBTQ+ community that “bottom surgery” – altering a penis or vagina – would be more significant than top surgery, Liebman said breast surgery has an even more profound impact.
“The chest is the most visible identifier of gender and breasts are hard to hide,” he said. But genitals are not visible to the public. And sexual preference is not synonymous with gender identity. A trans male, a person who is assigned female at birth, for instance, may prefer male or female sexual partners and that’s also true of trans women, he said.
Dr. Liebman’s practice reflects the rapid change in society’s understanding of gender dysphoria and the medical necessity to correct mismatched bodies and souls. “I’d say things began to change about ten years ago,” he said, and now a substantial part of his practice is focused on gender transformation.
While things have changed, Dr. Liebman said he’s still one of the few surgeons who accepts Medicare and Medicaid. And while it wasn’t uncommon in the past for procedures to be rejected for insurance coverage, they are now routinely approved. Liebman gave credit to the Affordable Care Act, in part, for changing the circumstances by prohibiting discrimination on the basis of sex and expanding access to Medicaid.
Liebman said he’s often asked whether he has broader connections to the transgender community than providing surgery. He doesn’t. He’s a divorced father of two who’s a fierce advocate for his trans patients, but isn’t otherwise an activist. His time outside of work is spent with his daughters and his guitar.
Few surgeries are as transforming as gender correction, and Dr. Liebman is often reminded of the impact it has on his patients. “I was walking around Center City, where I live, and a patient came up to me and hugged me and said, ‘You have changed my life.’ I hear it often,” Liebman said.
“It’s gratifying that something relatively simple that I do can have such a profound effect.”
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