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Development of a decision aid for genital surgery in transmen (DA-GST)

Ozer, M1; Bouman, M1; Pigot, GLS1; Elfering, L1; Buncamper, M1; Mullender, MG1

1: Vumc, Netherlands

Objectives: Multiple options exist for masculinizing genital surgery. The outcomes vary with regard to removal of female reproductive organs, the urologic function, sexual functions and the cosmetic result. Also risk of complications and patient burden differs between treatments. Weighing all of these issues to come to a good decision is challenging for both patient and surgeon. For this reason, a tool which can assist both patients and health care professionals in making a well-informed decision about the treatment is particularly necessary. Hence, we aim to develop a Decision Aid for Genital Surgery in Transmen (DA-GST).

Material and Methods: A mixed methods research design was used. Focus groups with both health care professionals (HCP) and transmen were selected as the best method to collect information. We organized five focus groups consist of both transmen and health care professionals, led by independent professional moderators. Data collected during these focus groups were analysed to provide content for the DA.

Results: Data collected during the focus groups related to the treatment options, information deemed relevant by the patient, and the arguments for or against each treatment option. Items collected from the group were divided into the following themes: Genital Ideal, Risks, Health, Preconditions, Costs, Time, Process, Burden, Self-efficacy, Technique, Results, Fertility, Environment, Believes and Sexuality. 

Conclusion: This decision aid concerns all surgical options for removal of reproductive organs and/or genital identity confirming surgeries in transmen. The tool is useful in assisting transmen in their decision-making process by giving arguments against or for specific options and to assist health care professionals to explore which domains are most relevant for each specific individual.


Work supported by industry: no, by ESSM (no industry support in study design or execution).

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