Development of a Decision Aid for Genital Gender-Affirming Surgery in Transmen

Abstract

Background As genital gender-affirming surgery (GAS) is a demanding and life-changing intervention, transmen should be able to make choices about the surgical treatment based on outcomes that are most important to them, while taking into consideration the concomitant risks involved. Aim Develop a decision aid (DA) for genital surgery in transmen (DA-GST) that can assist both transmen and health care professionals (HCPs) in making a well-informed decision about the surgical treatment. Methods A qualitative focus group study was performed. 5 Focus groups were organized with both HCPs and transmen. These were led by an independent professional moderator. Data collected during these focus groups were analyzed to provide content for the DA. Outcomes To develop content for a DA-GST. Results Data collected during the focus groups related to the treatment options, information deemed relevant by transmen, and the arguments for or against each treatment option. Collected items were divided into the following themes: outcome, quality of life, environment, sexuality, and beliefs. Clinical Implications The tool will be useful in assisting both transmen and HCPs in the shared decision-making process regarding genital GAS by exploring which domains are most relevant for each specific individual. Strengths & Limitations This DA was developed according to an iterative participatory design approach to fit the needs of both transmen and HCPs. Issues that transmen find important and relevant pertaining to genital GAS were translated into arguments that were incorporated in the DA-GST. The study is limited by the group that had participated. Not all arguments for or against specific surgical options may be covered by the DA-GST. Conclusion An online DA was developed to support transmen with their decision-making process concerning all surgical options for removal of reproductive organs and genital GAS.

Lipid metabolism in cancer progression and therapeutic strategies

“…237 Etomoxir can improve the efficiency of chemotherapy in lymphoma when used in combination therapy 238 . In addition, combined therapy targeting of the FAO and VEGF pathways was found to produce superior anticancer effects when compared with monotherapies, suggesting the efficacy of CPT1 inhibitors to overcome the antiangiogenic drug (AAD) resistance 239 . These findings strongly suggest the potential of CPT1 as a therapeutic target for cancer treatment.…”

Evaluation of the Decision Aid for Genital Surgery in Transmen

“…The aim of this study was to evaluate the developed DA-GST, for transmen considering genital surgery, and to assess its added value to the decision-making process. 1,45 A cross-sectional study with the mixed-method design was used to assess DC using questionnaires while also qualitatively querying the experiences with the developed tool.…”

“…Correspondingly, the demand for surgical treatment is ever increasing. 1 In addition, views on the concepts "gender" and "gender identity" have been changing from binary concepts (men or women) to a more fluid spectrum.…”

“…To inform transmen about the surgical options and identify their individual preferred outcome, a decision aid was developed. 1,25 This decision aid, "Genital Surgery in Transmen"(DA-GST) is online and available to the public. 26 This instrument is designed to provide information regarding the surgical options, based on arguments provided by transmen.…”

Urologische zorg bij transgenders in Nederland

“…Dit zijn allemaal punten die medebepalend zijn. Om een meer weloverwogen beslissing te kunnen nemen voor het type genitale GAO is voor de transmannen een keuzehulp ontwikkeld [5]. Uiteindelijk wordt op basis van de wens van de patiënt en de fysieke, psychische en urologische factoren tot een gezamenlijke beslissing gekomen ten aanzien van het type genitale geslachtsaanpassende operatie.…”