gender reassignment benefits

Mental health benefits associated with gender-affirming surgery

Staff Writer

Gender-affirming surgeries are associated with numerous positive health benefits, including lower rates of psychological distress and suicidal ideation, as well as lower rates of smoking , according to new research led by Harvard T.H. Chan School of Public Health.

The study examined data from the 2015 U.S. Transgender Survey, which included nearly 20,000 participants, 38.8% of whom identified as transgender women, 32.5% of whom identified as transgender men, and 26.6% of whom identified as nonbinary. Of the respondents, 12.8% had undergone gender-affirming surgery at least two years prior and 59.2% wanted to undergo surgery but had not done so yet.

Gender-affirming surgeries were associated with a 42% reduction in psychological distress and a 44% reduction in suicidal ideation when compared with transgender and gender-diverse people who had not had gender-affirming surgery but wanted it, according to the findings. The study also found a 35% reduction in tobacco smoking among people who had gender-affirming surgeries.

“Going into this study, we certainly did believe that the gender-affirming surgeries would be protective against adverse mental health outcomes,” lead author Anthony Almazan, an MPH candidate at Harvard Chan School, said in an April 28, 2021, HealthDay article. “I think we were pleasantly surprised by the strength of the magnitudes of these associations, which really are very impressive and, in our opinion, speaks to the importance of gender-affirming surgery as medically necessary treatment for transgender and gender diverse people who are seeking out this kind of affirmation.”

Read the HealthDay article: Gender-Affirming Surgeries Improve Mental Health in Young, Study Says

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Life After Gender Affirming Surgery: Five Benefits

• Life After Gender Affirming Surgery Five Benefits

Gender affirming surgery includes a wide variety of surgeries for those transitioning from male to female or female to male to help with gender dysphoria. There are many different types of surgeries that can be considered gender affirming surgery but they all have the goal of helping the patient affirm the gender they identify as and are transitioning to. These different surgeries help the patient look and feel more masculine or feminine and are greatly beneficial to the patient and their overall journey. 

Different surgery options include, but are not limited to:

• Body contouring
• Rhinoplasty
• Breast augmentation
• Buttock/hip enhancement
• Rib reduction
• Vaginoplasty
• Phalloplasty
• Masculinizing chest surgery
• Facial feminization surgery
• Voice surgery
• Tracheal shave
• Facial masculinization surgery

Knowing the benefits of surgery beforehand can greatly help patients make the right decision about whether to move forward with their desired surgery with peace of mind.

Below we’ll discuss five benefits of gender affirming surgeries and what patients can look forward to with life after. 

Long-Term Mental Health Benefits

Research shows that one of the main benefits of gender affirming surgery is the wide array of long-term mental health benefits patients experience. Some studies report that patients who underwent gender affirming surgeries experienced lower rates of psychological distress and suicidal ideation. Another study found that a person’s odds for needing mental health treatment declined by 8% each year after gender affirming surgery.

More and more studies showing the large number of mental health benefits patients are experiencing post-surgery confirm the importance of gender procedures as medically necessary treatments for transgender people.

Higher Quality of Life

Many transgender patients before undergoing gender affirming procedures are looking to have a higher quality of life living as their identifying gender and believe that gender affirming procedures will help provide that. As you might imagine, a higher quality of life is a benefit many patients experience after undergoing surgery. While hormone therapy can make a big difference in one’s transition journey, gender affirming procedures are essential for helping transgender people truly look and feel like themselves. 

One study measuring transgender patients’ overall quality of life post-surgery found that three-quarters of patients who underwent a gender affirming surgery have a better quality of life now.

Improved Sexuality

One main concern for transgender people is how their sexuality and experience will change throughout their transition journey. This is especially true for patients who desire to undergo any type of bottom surgery. Common concerns brought up by patients are their ability to experience sexual satisfaction after surgery. Fortunately, many studies have found that transgender patients have reported that they experienced higher levels of sexual satisfaction after gender surgery.

One study shows that over 75% of patients were able to achieve orgasm after surgery. Transgender patients have reported being able to reach orgasm more easily and experience more frequent sexual satisfaction than they had before surgery. 

Better Self Image

A number of pre-surgery transgender patients struggle with low self-image, self-esteem, and with positive body image because they don’t look and feel masculine or feminine enough. One of the benefits many patients hope to experience from surgery is feeling more confident in themselves and their gender. One study of transgender men showed that participants had lower self-esteem than cis-gender men and that a mastectomy improved their body image, self-esteem, and self-worth.

Improved Social Affirmation

While transgender people can make a lot of nonsurgical changes to more closely identify with their gender for themselves and to signal others, it can feel challenging for many to affirm their gender socially and feel accepted pre-gender affirming surgery. For some people, changing their pronouns, name, and clothing doesn’t feel like enough to fit in.

Gender affirming surgery allows a trans patient’s physical attributes to align more closely with their self-identified gender and appear as their self-identified gender to others as well. Not only do gender affirming surgeries help trans patients feel more socially accepted, but they also help patients feel more confident overall in public and social settings. 

The Bottom Line

As gender affirming surgeries are being studied more and more, the known benefits of life after surgery continue to grow. It’s clear that gender affirming surgeries are a necessity for overall quality of life for transgender people. While many patients have concerns before going through these big, life-changing procedures, knowing the benefits that lie ahead can be comforting. 

In addition to knowing the benefits, it’s also essential to undergo a consultation with a surgeon before making any final decisions. This ensures that you’re a good candidate for surgery and that you choose the best procedures to reach your desired outcome.

Ready to get started on your gender affirming surgery journey? Leif Rogers, MD, is an Ivy League-educated, board-certified plastic surgeon and a standing member of the American Society of Plastic Surgeons. To schedule a consultation, get in touch with our team today.

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Demystifying and Navigating Your Options: Gender Reassignment Surgery

Medically reviewed by Paul Gonzales on March 25, 2024.

Previously, the term gender reassignment surgery (GRS) referred to genital reconstruction bottom surgeries like vaginoplasty, vulvoplasty, phalloplasty, or metoidioplasty. Individuals who look up this term on a search engine do so looking for information on gender-affirming procedures generally for transgender, non-binary and gender non-conforming people. This detailed guide breaks down everything you need to know about these procedures, their costs, their eligibility requirements, the potential benefits and risks and more. If you are interested in undergoing any gender-affirming or “gender reassignment” surgery, you can schedule a free, virtual consultation with one of our surgeons.

At the Gender Confirmation Center (GCC), we generally avoid using terminology like GRS in a clinical setting out of the recognition that for the vast majority of our patients, surgeries do not “reassign” anyone’s gender. Rather, surgery can help individuals experience greater alignment with their bodies and greater gender euphoria as a result.

Types of Gender “Reassignment” Surgeries: “Female to Male (FTM)”

Female to Male (FTM) is outdated terminology that the GCC does not use in our clinical practice. This abbreviation leaves out the experiences of many trans masculine and non-binary patients who do not identify with being labeled as a “woman becoming a man.” 

In the past, “FTM gender confirmation surgery” was used to describe surgical procedures that reverse the effects of an initial estrogenic puberty or procedures that reconstruct a patient’s genitals. We still receive various inquiries about which “FTM” procedures we offer, so below you can find a list of surgeries that have typically been placed under this label. 

Please note that patients can seek out any of these procedures regardless of their gender identity. The goal of our practice is not to make our patients “into men,” but to help them feel more comfortable, affirmed, and/or aligned with their bodies.

Chest Surgery or Top Surgery

“FTM” top surgery is an antiquated term that refers to gender-affirming chest reconstruction and/or breast reduction. Practices who use this acronym sometimes have limited experience meeting the unique needs of non-binary patients seeking top surgery . Patients who would like to remove their chest tissue to have a flatter chest can choose from a variety of incision options to reach their desired results around chest tightness, contour and/or scar shape. 

Not all patients who pursue top surgery want flat chests. Whether you would like to opt for a breast reduction or a chest reconstruction with some volume left behind, the button buttonhole incision is the most commonly pursued type.

Top surgery patients who would like to maintain an erotic or a high level of sensation in their nipples can ask their surgeon about nerve-preservation techniques . Inversely, many patients who get top surgery choose to have their nipples removed .

Genital Reconstruction or Bottom Surgery

While the following bottom surgery procedures are traditionally put under the “FTM” category, we recognize that not all patients who pursue these procedures identify as men nor are they looking to “masculinize” their genitals.

More Articles

Understanding the cost of double incision top surgery: a comprehensive guide, gatekeeping vs. empowerment: accessing gender affirming care, treating gender dysphoria in adolescents, request a free surgical consultation today..

All virtual and in-person consultations with our board-certified surgeons are free. Once you fill out this form, our patient care team will reach out and guide you through every step to get to surgery.

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Mental health benefits associated with gender-affirming surgery.

Various pride flags are displayed at the Harvard T.H. Chan School of Public Health. Kris Snibbe/Harvard file photo

Gender-affirming surgeries are associated with numerous positive health benefits, including lower rates of psychological distress and suicidal ideation, as well as lower rates of smoking, according to new research led by Harvard T.H. Chan School of Public Health.

The study examined data from the 2015 U.S. Transgender Survey, which included nearly 20,000 participants, 38.8 percent of whom identified as transgender women, 32.5 percent of whom identified as transgender men, and 26.6 percent of whom identified as nonbinary. Of the respondents, 12.8 percent had undergone gender-affirming surgery at least two years prior and 59.2 percent wanted to undergo surgery but had not done so yet.

Gender-affirming surgeries were associated with a 42 percent reduction in psychological distress and a 44 percent reduction in suicidal ideation when compared with transgender and gender-diverse people who had not had gender-affirming surgery but wanted it, according to the findings. The study also found a 35 percent reduction in tobacco smoking among people who had gender-affirming surgeries.

“Going into this study, we certainly did believe that the gender-affirming surgeries would be protective against adverse mental health outcomes,” lead author Anthony Almazan, an M.P.H. candidate at Harvard Chan School, said in an April 28, 2021, HealthDay article. “I think we were pleasantly surprised by the strength of the magnitudes of these associations, which really are very impressive and, in our opinion, speaks to the importance of gender-affirming surgery as medically necessary treatment for transgender and gender diverse people who are seeking out this kind of affirmation.”

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Preparation and Procedures Involved in Gender Affirmation Surgeries

If you or a loved one are considering gender affirmation surgery , you are probably wondering what steps you must go through before the surgery can be done. Let's look at what is required to be a candidate for these surgeries, the potential positive effects and side effects of hormonal therapy, and the types of surgeries that are available.

Gender affirmation surgery, also known as gender confirmation surgery, is performed to align or transition individuals with gender dysphoria to their true gender.

A transgender woman, man, or non-binary person may choose to undergo gender affirmation surgery.

The term "transexual" was previously used by the medical community to describe people who undergo gender affirmation surgery. The term is no longer accepted by many members of the trans community as it is often weaponized as a slur. While some trans people do identify as "transexual", it is best to use the term "transgender" to describe members of this community.

Transitioning

Transitioning may involve:

• Social transitioning : going by different pronouns, changing one’s style, adopting a new name, etc., to affirm one’s gender
• Medical transitioning : taking hormones and/or surgically removing or modifying genitals and reproductive organs

Transgender individuals do not need to undergo medical intervention to have valid identities.  

Reasons for Undergoing Surgery

Many transgender people experience a marked incongruence between their gender and their assigned sex at birth.   The American Psychiatric Association (APA) has identified this as gender dysphoria.

Gender dysphoria is the distress some trans people feel when their appearance does not reflect their gender. Dysphoria can be the cause of poor mental health or trigger mental illness in transgender people.

For these individuals, social transitioning, hormone therapy, and gender confirmation surgery permit their outside appearance to match their true gender.  

Steps Required Before Surgery

In addition to a comprehensive understanding of the procedures, hormones, and other risks involved in gender-affirming surgery, there are other steps that must be accomplished before surgery is performed. These steps are one way the medical community and insurance companies limit access to gender affirmative procedures.

Steps may include:

• Mental health evaluation : A mental health evaluation is required to look for any mental health concerns that could influence an individual’s mental state, and to assess a person’s readiness to undergo the physical and emotional stresses of the transition.  
• Clear and consistent documentation of gender dysphoria
• A "real life" test :   The individual must take on the role of their gender in everyday activities, both socially and professionally (known as “real-life experience” or “real-life test”).

Firstly, not all transgender experience physical body dysphoria. The “real life” test is also very dangerous to execute, as trans people have to make themselves vulnerable in public to be considered for affirmative procedures. When a trans person does not pass (easily identified as their gender), they can be clocked (found out to be transgender), putting them at risk for violence and discrimination.

Requiring trans people to conduct a “real-life” test despite the ongoing violence out transgender people face is extremely dangerous, especially because some transgender people only want surgery to lower their risk of experiencing transphobic violence.

Hormone Therapy & Transitioning

Hormone therapy involves taking progesterone, estrogen, or testosterone. An individual has to have undergone hormone therapy for a year before having gender affirmation surgery.  

The purpose of hormone therapy is to change the physical appearance to reflect gender identity.

Effects of Testosterone

When a trans person begins taking testosterone , changes include both a reduction in assigned female sexual characteristics and an increase in assigned male sexual characteristics.

Bodily changes can include:

• Beard and mustache growth  
• Deepening of the voice
• Enlargement of the clitoris  
• Increased growth of body hair
• Increased muscle mass and strength  
• Increase in the number of red blood cells
• Redistribution of fat from the breasts, hips, and thighs to the abdominal area  
• Development of acne, similar to male puberty
• Baldness or localized hair loss, especially at the temples and crown of the head  
• Atrophy of the uterus and ovaries, resulting in an inability to have children

Behavioral changes include:

• Aggression  
• Increased sex drive

Effects of Estrogen

When a trans person begins taking estrogen , changes include both a reduction in assigned male sexual characteristics and an increase in assigned female characteristics.

Changes to the body can include:

• Breast development  
• Loss of erection
• Shrinkage of testicles  
• Decreased acne
• Decreased facial and body hair
• Decreased muscle mass and strength  
• Softer and smoother skin
• Slowing of balding
• Redistribution of fat from abdomen to the hips, thighs, and buttocks  
• Decreased sex drive
• Mood swings  

When Are the Hormonal Therapy Effects Noticed?

The feminizing effects of estrogen and the masculinizing effects of testosterone may appear after the first couple of doses, although it may be several years before a person is satisfied with their transition.   This is especially true for breast development.

Timeline of Surgical Process

Surgery is delayed until at least one year after the start of hormone therapy and at least two years after a mental health evaluation. Once the surgical procedures begin, the amount of time until completion is variable depending on the number of procedures desired, recovery time, and more.

Transfeminine Surgeries

Transfeminine is an umbrella term inclusive of trans women and non-binary trans people who were assigned male at birth.

Most often, surgeries involved in gender affirmation surgery are broken down into those that occur above the belt (top surgery) and those below the belt (bottom surgery). Not everyone undergoes all of these surgeries, but procedures that may be considered for transfeminine individuals are listed below.

Top surgery includes:

• Breast augmentation  
• Facial feminization
• Nose surgery: Rhinoplasty may be done to narrow the nose and refine the tip.
• Eyebrows: A brow lift may be done to feminize the curvature and position of the eyebrows.  
• Jaw surgery: The jaw bone may be shaved down.
• Chin reduction: Chin reduction may be performed to soften the chin's angles.
• Cheekbones: Cheekbones may be enhanced, often via collagen injections as well as other plastic surgery techniques.  
• Lips: A lip lift may be done.
• Alteration to hairline  
• Male pattern hair removal
• Reduction of Adam’s apple  
• Voice change surgery

Bottom surgery includes:

• Removal of the penis (penectomy) and scrotum (orchiectomy)  
• Creation of a vagina and labia

Transmasculine Surgeries

Transmasculine is an umbrella term inclusive of trans men and non-binary trans people who were assigned female at birth.

Surgery for this group involves top surgery and bottom surgery as well.

Top surgery includes :

• Subcutaneous mastectomy/breast reduction surgery.
• Removal of the uterus and ovaries
• Creation of a penis and scrotum either through metoidioplasty and/or phalloplasty

Complications and Side Effects

Surgery is not without potential risks and complications. Estrogen therapy has been associated with an elevated risk of blood clots ( deep vein thrombosis and pulmonary emboli ) for transfeminine people.   There is also the potential of increased risk of breast cancer (even without hormones, breast cancer may develop).

Testosterone use in transmasculine people has been associated with an increase in blood pressure, insulin resistance, and lipid abnormalities, though it's not certain exactly what role these changes play in the development of heart disease.  

With surgery, there are surgical risks such as bleeding and infection, as well as side effects of anesthesia . Those who are considering these treatments should have a careful discussion with their doctor about potential risks related to hormone therapy as well as the surgeries.  

Cost of Gender Confirmation Surgery

Surgery can be prohibitively expensive for many transgender individuals. Costs including counseling, hormones, electrolysis, and operations can amount to well over $100,000. Transfeminine procedures tend to be more expensive than transmasculine ones. Health insurance sometimes covers a portion of the expenses.

Quality of Life After Surgery

Quality of life appears to improve after gender-affirming surgery for all trans people who medically transition. One 2017 study found that surgical satisfaction ranged from 94% to 100%.  

Since there are many steps and sometimes uncomfortable surgeries involved, this number supports the benefits of surgery for those who feel it is their best choice.

A Word From Verywell

Gender affirmation surgery is a lengthy process that begins with counseling and a mental health evaluation to determine if a person can be diagnosed with gender dysphoria.

After this is complete, hormonal treatment is begun with testosterone for transmasculine individuals and estrogen for transfeminine people. Some of the physical and behavioral changes associated with hormonal treatment are listed above.

After hormone therapy has been continued for at least one year, a number of surgical procedures may be considered. These are broken down into "top" procedures and "bottom" procedures.

Surgery is costly, but precise estimates are difficult due to many variables. Finding a surgeon who focuses solely on gender confirmation surgery and has performed many of these procedures is a plus.   Speaking to a surgeon's past patients can be a helpful way to gain insight on the physician's practices as well.

For those who follow through with these preparation steps, hormone treatment, and surgeries, studies show quality of life appears to improve. Many people who undergo these procedures express satisfaction with their results.

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T'sjoen G, Arcelus J, Gooren L, Klink DT, Tangpricha V. Endocrinology of transgender medicine . Endocr Rev . 2019;40(1):97-117. doi:10.1210/er.2018-00011

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Altman K. Facial feminization surgery: current state of the art . Int J Oral Maxillofac Surg . 2012;41(8):885-94.  doi:10.1016/j.ijom.2012.04.024

Therattil PJ, Hazim NY, Cohen WA, Keith JD. Esthetic reduction of the thyroid cartilage: A systematic review of chondrolaryngoplasty . JPRAS Open. 2019;22:27-32. doi:10.1016/j.jpra.2019.07.002

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Sex-reassignment surgery yields long-term mental health benefits, study finds

When transgender people undergo sex-reassignment surgery, the beneficial effect on their mental health is still evident — and increasing — years later, a Swedish study suggests.

Overall, people in the study with gender incongruence — that is, their biological gender doesn’t match the gender with which they identify — were six times more likely than people in the general population to visit a doctor for mood and anxiety disorders. They were also three times more likely to be prescribed antidepressants, and six times more likely to be hospitalized after a suicide attempt, researchers found.

But among trans people who had undergone gender-affirming surgery, the longer ago their surgery, the less likely they were to suffer anxiety, depression or suicidal behavior during the study period, researchers reported in The American Journal of Psychiatry.

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Surgery to modify a person’s sex characteristics “is often the last and the most considered step in the treatment process for gender dysphoria,” according to the World Professional Association for Transgender Health.

Many transgender and gender-nonconforming individuals "find comfort with their gender identity, role, and expression without surgery," but for others, "surgery is essential and medically necessary to alleviate their gender dysphoria," according to the organization.

While the new study confirms that transgender individuals are more likely to use mental health treatments, it also shows that gender-affirming therapy might reduce this risk, coauthor Richard Branstrom of the Karolinska Institutet in Stockholm told Reuters Health by email.

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Branstrom and colleague John Pachankis of the Yale School of Public Health in New Haven, Connecticut found that as of 2015, 2,679 people in Sweden had a diagnosis of gender incongruence, out of the total population of 9.7 million.

That year, 9.3 percent of people with gender incongruence visited a doctor for mood disorders, 7.4 percent saw a doctor for anxiety disorders and 29 percent were on antidepressants. In the general population, those percentages were 1 percent, 0.6 percent and 9.4 percent, respectively.

Just over 70 percent of people with gender incongruence were receiving feminizing or masculinizing hormones to modify outward sexual features such as breasts, body fat distribution and facial hair, and 48 percent had undergone gender-affirming surgery. Nearly all of those who had surgery also received hormone therapy.

The benefit of hormone treatment did not increase with time. But “increased time since last gender-affirming surgery was associated with fewer mental health treatments,” the authors report.

In fact, they note, “The likelihood of being treated for a mood or anxiety disorder was reduced by 8 percent for each year since the last gender-affirming surgery,” for up to 10 years.

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Transgender individuals’ use of mental health care still exceeded that of the general Swedish population, which the research team suggests is due at least partly to stigma, economic inequality and victimization.

“We need greater visibility and knowledge about challenges people are confronted with while breaking gender and identity norms,” Branstrom said.

Dr. Joshua Safer, executive director at Mount Sinai Center for Transgender Medicine and Surgery in New York City, told Reuters Health by email, “If anything, the study likely under-reports mental health benefits of medical and surgical care for transgender individuals.”

Safer, who was not involved in the study, said the fact that mental health continued to improve for years after surgery “suggests (surgery provides) extended and ongoing benefit to patients living according to gender identity.”

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A Systematic Review of the Psychological Benefits of Gender-Affirming Surgery

Affiliations.

• 1 Department of Child and Adolescent Psychiatry, Hassenfeld Children's Hospital at NYU Langone, 1 Park Avenue, 7th Floor, New York, NY 10016, USA. Electronic address: [email protected].
• 2 Department of Child and Adolescent Psychiatry, Hassenfeld Children's Hospital at NYU Langone, 1 Park Avenue, 7th Floor, New York, NY 10016, USA.
• 3 NYU Langone, Health Sciences Library, New York, NY, USA.
• 4 Ann and Robert H. Lurie Children's Hospital of Chicago, Department of Psychiatry, 225 E Chicago Avenue, Chicago, IL 60611, USA.
• PMID: 31582022
• DOI: 10.1016/j.ucl.2019.07.002

For individuals with gender dysphoria, gender-affirming surgeries (GAS) are one means of reducing the significant distress associated with primary and secondary sex characteristics misaligned with their gender identity. This article uses a systematic review to examine the existing literature on the psychological benefits of GAS. Findings from this review indicate that GAS can lead to multiple, significant improvements in psychological functioning. Methodological differences in the literature demonstrate the need for additional research to draw more definitive conclusions about the psychological benefits of GAS.

Keywords: Gender dysphoria; Gender-affirming surgery; Mental health; Transgender health; Well-being.

Copyright © 2019 Elsevier Inc. All rights reserved.

Publication types

• Systematic Review
• Gender Dysphoria / psychology*
• Gender Dysphoria / surgery*
• Sex Reassignment Surgery / psychology*

Word on Benefits

International Foundation Blog

The Rise of Gender-Affirmation Health Care Benefits

Gender-affirmation health care benefit offerings have been on the rise over the past seven years, according to survey data from the International Foundation. Up from 12 percent in 2016, 30 percent of U.S. employers now offer the benefit.

I spoke with Julie Stich, CEBS, Vice President of Content at the Foundation, more about this topic. She said, when searching for meaningful employment, individuals look for employers with cultures that resonate. Often this involves inclusiveness and employers that offer a range of benefits to serve a diverse population.

According to  Employee Benefits Survey: 2022 Results , among U.S. employer-provided health plans providing the benefit:

• 27% offer gender-reassignment/affirmation surgery (8% in 2016, 22% in 2018)
• 25% cover prescription drug therapy (hormone replacement therapy, etc.) (9% in 2016, 24% in 2018)
• 26% include physician visits (10% in 2016, 24% in 2018)
• 21% cover lab tests (9% in 2016, 23% in 2018)
• 20% include cosmetic surgery (facial feminization, Adam’s apple reduction, etc.) (2% in 2016, 3% in 2018)

Offering gender-affirmation health care benefits is a way for employers to remain competitive in attracting and retaining talent. This type of offering reinforces a culture of inclusion and belonging.

For more information on Employee Benefits Survey: 2022 Results, visit www.ifebp.org/ebs2022 .

Anne Patterson

Marketing Communications Manager Favorite Foundation Product:  Foundation Community. It’s like LinkedIn but only for Foundation members. They can post questions, share best practices, etc—all with fellow members who also live and breathe employee benefits. Benefits-related Topics That Interest Her Most:  Workplace wellness (especially mental health), diversity, equity and inclusion, behavioral decision making, family-friendly benefits, payroll audits. Personal Insight:  When she’s not busy analyzing the inner workings of her toddler’s brain (does anyone actually know?!), Anne finds joy in home renovation and décor, haiku writing, watching Jeopardy, creating charcuterie boards, and bicycling.

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