Robert Wood Johnson University Hospital (RWJUH) Somerset, an RWJBarnabas Health facility, recently performed its first gender affirmation surgery for a transgender woman. It is one of only two hospitals in New Jersey and one of only a handful in the Northeast to perform “bottom surgery.” The six-hour procedure involves the use of the daVinci robotic surgical system and often includes an orchiectomy, penectomy (removal of the testicles and penis), creation of a new urethra, feminizing genitoplasty and creation of a vaginal canal.
“We were proud to lead the way in New Jersey as the first in the state to provide specialized primary care services for the LGBTQ+ community at our Babs Siperstein PROUD Center,” said Tony Cava, president and chief executive officer of Robert Wood Johnson University Hospital Somerset. “With the addition of gender affirmation surgery, we can now offer the full scope of LGBTQ+ medical care, from HIV prevention and wellness checkups to hormone therapy, behavioral health services and surgery.”
The gender affirmation surgeries are performed by plastic surgeon Jonathan Keith, MD, and urologist and robotic surgeon Nitin Patel, MD, who have collaborated on nearly 100 procedures since performing their first gender affirmation surgery – a radial artery-based forearm phalloplasty – at Cooperman Barnabas Medical Center in Livingston in 2018. They continue performing gender affirmation surgeries at Cooperman Barnabas Medical Center, which is also part of the RWJBarnabas Health system.
Dr. Keith is a fellowship-trained and board-certified plastic surgeon who specializes in microvascular surgery. He is a member of the World Professional Association for Transgender Health and founder of the Rutgers Center for Transgender Health. He founded the first multidisciplinary clinical program for transgender patients in New Jersey and was the first surgeon in the state to perform a female-to-male phalloplasty for gender affirmation. He obtained his medical degree from the University of Pittsburgh, where he completed his plastic surgery residency. He completed his fellowship at Gent Belgium University Hospital in Belgium.
Dr. Patel, a member of RWJBarnabas Health Medical Group, is a urologist with expertise in robotic, reconstructive and transgender surgery. He obtained his medical degree from University of Medicine and Dentistry of New Jersey, where he completed his urology residency. Prior to joining RWJBarnabas Health, he served as Assistant Professor and Assistant Program Director at Rutgers New Jersey Medical School in the Division of Urology. He also served as chair for the Robotics Committee while pioneering the use of robotic surgery at University Hospital for reconstruction and transgender surgery.
The partnership between Drs. Keith and Patel is unique. In most cases, gender affirmation surgeries are performed by either a plastic surgeon or a urologist, not both, and may require multiple staged procedures.
“Patients benefit from our experience and our multidisciplinary approach because gender affirmation surgery is a very complex surgical procedure,” said Dr. Patel. “The use of the daVinci robotic surgical system allows us to be more precise and accurate and requires smaller incisions, reducing the risk of complications and resulting in better patient outcomes.”
The hospital’s surgical and inpatient care nurses have been specially trained in the care of gender affirmation surgery patients. A patient navigator from the Babs Siperstein PROUD Center is with the patient through every step of their hospital experience, from meeting them early in the morning on the day of their surgery to checking in on them multiple times a day throughout their week-long hospital stay and following up with them after discharge.
“At Robert Wood Johnson University Hospital Somerset, patients know they can come to a place where they will be treated in a respectful manner and they can feel safe,” said Dr. Keith. “They also have comprehensive supportive services available here through the Babs Siperstein PROUD Center.”
Originally starting as a one-night-a-week clinic, the center served just over 200 patients in its first year. In 2019, it was renamed the Babs Siperstein PROUD Center in memory of transgender activist Barbra “Babs” Casbar Siperstein and moved into a new space to accommodate a growing patient population.
Marking its fifth anniversary this year, the Babs Siperstein PROUD Center serves more than 1,400 patients and is open five days a week offering primary medical care, hormone therapy and monitoring, HIV care, health education, counseling and support groups.
Candidates for gender affirmation surgery must be at least 18 years old; have undergone one year of hormone therapy; have identified as their gender for at least one year and have a psychiatric evaluation to confirm their gender identity. The surgery is covered by most major medical insurances.
“It is so rewarding for me to be able to help patients be their authentic selves,” said Dr. Keith.
To schedule an appointment at the Babs Siperstein PROUD Center, call 908-243-8647. For more information, visit rwjbh.org/somersetproud.