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Page 119 Koss et al. Art Int Surg. 2025;5:116-25 https://dx.doi.org/10.20517/ais.2024.91

Data analysis/statistics
Descriptive statistics were used to summarize participant characteristics and study variables. Frequencies
and percentages were calculated for categorical variables, while means and standard deviations were
calculated for continuous variables. All statistical analyses were conducted using STATA/IC software
(StataCorp LP, College Station, Texas).

RESULTS
Among the 207 participants, 100% reported that their current gender differs from their assigned gender at
birth. The majority identified as non-binary (40.6%), followed by transgender men (29.5%) and transgender
women (13%), with an average age of 30.2 years [Table 1]. A high level of interest in GAS was observed,
with 89% expressing interest [Table 2]. When seeking information about GAS, participants primarily relied
on online forums or communities such as Reddit and Tumblr (24.6%) and medical websites such as
WebMD and Mayo Clinic (21.3%). Social media platforms were also frequently used (17.4%), alongside
healthcare professionals (15%) and personal stories (13.5%) [Figure 1].

Regarding the use of ChatGPT, 73% of participants had used the platform, though only a small subset
(6.7%) used it specifically as a resource for GAS information. Participants who used ChatGPT for GAS
information generally had positive perceptions, with 70% rating the information as moderately to slightly
useful. Additionally, 40% of users felt ChatGPT had a positive influence on their decision-making process,
and 80% expressed moderate to high levels of trust in the information provided.

When comparing ChatGPT’s information to other sources, 25% of users found it comparable to advice from
healthcare providers, while 60% viewed it as similar to information found on medical websites. However,
20% considered ChatGPT’s information somewhat worse than that on medical websites, and 30% found it
somewhat worse than scientific journals. Despite these varied opinions, a majority (60%) of ChatGPT users
indicated they would recommend the tool to peers considering GAS.

Participants used ChatGPT to search for various GAS-related topics, with the most common being facial
feminization, facial masculinization, and mastectomy (18.2% each). Other frequently queried topics
included metoidioplasty, phalloplasty, and breast augmentation (13.6% each). 30% of participants used
ChatGPT to learn about surgeon information. Many also sought information about surgical risks,
techniques, and recovery processes, although some felt the platform provided insufficient detail on financial
considerations (23.1%) and recovery information (15.4%). Despite these limitations, ChatGPT was seen by
many as a useful supplementary resource.

Several participants shared their personal thoughts and experiences using ChatGPT for GAS information.
One participant noted that “ChatGPT gave a detailed explanation of what gender-affirming surgery is”,
while another commented that it “can be efficient to an extent”. Others appreciated its straightforwardness,
with one remarking that it was “pretty accurate to what I wanted to know... and straight to the point”.

DISCUSSION
This study aimed to characterize the use of ChatGPT as a resource for obtaining information about GAS
among transgender and gender-diverse individuals in the United States. While most participants had used
ChatGPT, its application specifically for GAS information was notably limited compared to more traditional
resources such as online forums and medical websites. These findings align with prior research suggesting
that patients navigating complex health decisions, such as GAS, prefer personalized, human-centered
resources over automated tools [9,10] . There are several reasons why participants may not have wanted to use