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gender-affirming care, undergoing 1 or more types of gender-affirming surgery was associated with lower past-month psychological distress (adjusted odds ratio [aOR], 0.58; 95% CI, 0.50-0.67; P  .001), past-year smoking (aOR, 0.65; 95% CI, 0.57-0.75; P  .001), and past-year suicidal ideation (aOR, 0.56; 95% CI, 0.50-0.64; P  .001). This study demonstrates an association between gender-affirming surgery and improved mental health outcomes. These results contribute new evidence to support the provision of gender-affirming surgi

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