Assessing gender dysphoria: A systematic review of patient-reported outcome measures.

Abstract

Over the last decade, the manner in which gender dysphoria is defined has changed significantly, as have the presentations of transgender clients to specialist gender services. Although the use of patientreported outcome measures (PROMs) to assess gender dysphoria is widespread, there is a lack of literature that assesses the methodological quality of these measures. To address the limits of the existing literature, the aim of the current study was to conduct a systematic review of PROMs that assess gender dysphoria. The systematic review was performed in accordance with the PRISMA and COSMIN methodologies. Five measurement studies met inclusion criteria. Results suggested that none of the measures could be recommended for use without further development. Poor content validity was evident across all measures and internal validity and construct validity were mixed, ranging from inadequate to very good. Measures that show promise for the future include the Gender Congruence and Life Satisfaction Scale, Gender Identity Reflection and Rumination Scale, Gender Preoccupation and Stability Questionnaire, and Transgender Adaptation and Integration Measure. A need to develop reliable and valid measures that are appropriate for use with adolescent samples experiencing gender dysphoria was also identified. Public Significance StatementFor clinicians, the study highlights the strengths and weaknesses of existing measures of gender dysphoria. For researchers, the study identifies additional research necessary to improve the methodological quality and measurement properties of the identified measures.

Clinical guidelines for children and adolescents experiencing gender dysphoria or incongruence: a systematic review of recommendations (part 2)

“…Few guidelines recommend exploring sexual orientation or assessing body image, despite these being identified as important factors 1 18 53. Few recommend specific assessment tools, and those suggested have not been developed and/or validated for this population 54–56…”

Gender services for children and adolescents across the EU-15+ countries: an online survey

“…The assessment processes shared common elements across services; most offered multiple appointments and covered similar core domains. The use of different tools to assess gender or co-occurring conditions was much less consistent and of the 14 gender-related tools reportedly used, only three are validated for this population38: Gender Preoccupation and Stability Questionnaire-2,39 Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults, 40 and Recalled Childhood Gender Identity Scale 41…”

Untitled

“…While one's experience of gender may be very real for those suffering from gender dysphoria, there are no objective criteria for assessing gender, and studies that are done to assess gender need further development to improve reliability. 37 It seems that most cases of gender dysphoria involve a gender binary, but assuming a developmental process of gender formation, one can certainly imagine exceptions to this pattern. 38 Note that, as mentioned earlier, we must still distinguish between variations in sex-typical behaviors and one's gender.…”