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Development, validation, and results from a novel inventory to assess and compare gender dysphoria before and after genital gender affirming surgery

Garcia, M1; Karasic, D2

1: Cedars-Sinai Medical Center, United States; 2: University of California San Francisco

Objectives: The medical indication for genital gender affirming surgery (GAS) is the diagnosis of gender dysphoria. The goal of GAS is to at least alleviate and reduce gender dysphoria. However, to date, no inventory that measures/quantifies the degree of gender dysphoria a patient associates with his or her body has been described. Furthermore, no inventory for gender dysphoria allows for pre and post-surgery assessment of gender dysphoria, to allow measurement of the effect of specific gender affirming surgeries to reduce gender dysphoria for transgender patients. We describe a novel questionnaire that we developed expressly for this purpose. We also describe two additional validated and commonly used inventories for depression/anxiety and quality of life, which we use with our inventory with transgender patients presenting to our centers for genital GAS.

Materials and Methods: We describe a 20-question inventory comprised of 12 questions to assess the degree to which a patient’s body contributes to their global gender dysphoria, 2 questions that assess the degree to which the patients genital areas contribute to their gobal gender dysphoria, and 6 questions that specifically assess measurable change in gender dysphoria after genital surgery.

We validated this questionnaire among transgender patients and transgender health professionals, yielding to recommended changes in wording and inventory item structure.

Results: We describe our approach to validate our inventory.We present the various questions from the questionnaire we developed, and , highlight an overview of the already validated inventories we co-administer to patients (WHOQOL-BREF for global QOL and the PHQ-9 for depression/anxiety). We review outcomes from our patients comparing inventory results before and after genital gender affirming surgery, which unequivocally demonstrate that gender dysphoria and depression/anxiety are reduced significantly, and quality of life is improved significantly, with genital gender affirming surgery.

Conclusions: The novel gender dysphoria inventory we developed and validated appears to measure changes in gender dysphoria after genital gender affirming surgery, which supports the rationale for such surgeries. Furthermore, we propose that this same inventory could be used to measure changes in gender dysphoria after non-genital surgeries.  


Work supported by industry: no. The presenter or any of the authors act as a consultant, employee (part time or full time) or shareholder of an industry.

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