Doctor of Armenian descent first surgical fellow of transgender surgery training program

The surge in demand for transgender surgeries in the United States has triggered a New York City hospital to launch a program to train doctors to perform gender reassignment procedures.

Mount Sinai's Center for Transgender Medicine and Surgery opened early last year in Manhattan and has since operated on roughly 350 patients.

Dr Jess Ting, the center's director of surgery, said the team operates on nearly four patients a week.

But even still, transgender patients experience disproportionate health inequities: only about five hours of medical school training are spent covering issues related to their health.

In an effort to address those inequities, the center has created two year-long fellowships to train a new transgender surgeons and psychiatrists to be able to work with these individuals.

The new program comes as the Trump administration prepares to roll back protections for transgender Americans. 

Surgeons in the field claim that figure is a conservative estimate - and would likely three times higher if all hospitals had a uniform way of documenting such surgeries.

At Mount Sinai there are roughly 500 patients awaiting gender confirmation surgery.

Dr Ting explained that this is because he is the only surgeon with the expertise to perform these surgeries.

'There's only so many patients I can see at a time,' Dr Ting told Daily Mail Online.

So in July the team launched the country's first transgender surgery fellowship which lasts for one year.

During the fellowship the participants will assist and perform surgery, teach residents and medical students and conduct transgender-related research.

Dr Bella Avanessian is the first surgical fellow, and came to Mount Sinai after completing a residency in plastic surgery.

Male to female genital surgery is called vaginoplasty; female to male genital surgery is called phalloplasty. There are various techniques and ways to perform each procedure.

'I decided to switch to gender confirmation surgery because I felt it would be more impactful in a city with 500 plastic surgeons and no transgender surgeons,' Dr Ting explained.

'And the surgeries are beautiful and intricate and complicated. It's so satisfying technically and aesthetically to be able to be able to change someone's life so much. It's a privilege.' 

The fellowship will train one new surgeon who can perform the gender confirmation surgeries each year.

By the time Dr Avanessian finishes her year, Dr Ting said she will be very sought after since there are no other specially-trained surgeons in the field.

Forty percent of transgender adults have attempted or seriously thought about suicide, a rate which is nine times higher than the general population.

So to go along with the surgical fellowship, Mount Sinai also launched a psychiatry fellowship directed by Dr Hansel Arroyo.

Plastic surgeons often partner with other experts to provide comprehensive care, such as doctors who specialize in hormone therapy or urology and with mental health professionals who help patients through the emotional aspects of their transition.

In 2016, Boston Medical Center became the first hospital in Massachusetts to offer the surgery, and at the University of Maryland Medical Center in Baltimore surgeons normally complete two of the operations a week. Other hospitals that offer the surgeries are the University of Michigan Medical Health system and the Hahnemann University Hospital in Philadelphia.

The Mount Sinai Icahn School of Medicine is the first and only to offer a program to train people specifically to perform gender reassignment surgeries.

Though the growth in transgender medicine is giving hope to patients and experts in the field, some wonder whether it will continue under the new administration.

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