ArticleInternational journal of transgender health2025
Decision-making in feminizing genital gender-affirming surgery - the effect of the introduction of the GenderAid decision-aid.
Article in International journal of transgender health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Puberty suppression and sexual well-being in transgender and gender-diverse individuals: evidence- and experience-based counselling and future research directions.Nature reviews. Urology · 2026Review
- A core outcome set for research on masculinizing genital gender-affirming surgery: international consensus results from the GenderCOS project.EClinicalMedicine · 2025Article
- The GenderCOS project: study protocol for the development of two international Core Outcome Sets for genital gender affirming surgery.International journal of transgender health · 2025Article
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Authors and funding
4 authors.
Funding
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Abstract
Introduction: Transgender individuals considering feminizing genital gender-affirming surgery (gGAS) face multiple options and potential decisional conflict (DC). Shared decision-making (SDM) between patients and healthcare professionals (HCPs) can support personalized care and improve outcomes. To aid trans women during the decision-making process for gGAS, a decision aid, the GenderAid (GA), was developed. Methods: This study aimed to investigate the effect of the GA on SDM and DC levels during the decision-making process for feminizing gGAS. An observational cross-sectional mixed methods study was conducted at the departments of Psychology and Plastic Surgery at the Center of Expertise on Gender Dysphoria of the Amsterdam UMC between 2020 and 2023. Questionnaires administered before and after implementing the GA included the validated translations of the SDM-Q-doc and SDM-Q-9 and the Decisional Conflict Scale. Qualitative data from interviews explored trans women's perceptions of the concepts of SDM and DC when deciding on feminizing gGAS. Results: Significantly higher levels of SDM experienced by trans women were observed after the introduction of the GA, while no such difference was observed for HCPs. The GA facilitated more thorough discussions with HCPs, and trans women felt well prepared for consultations by the decision-aid. DC was low before and after introduction of the GA; however, both quantitative as qualitative data revealed trans women experienced uncertainties during the process, due to new information on (non-)surgical options for gGAS. Discussion: This study suggests that the GA enhanced SDM in individuals seeking feminizing gGAS and had limited impact on DC by offering extensive information on all (non-)surgical options. However, the improved information overview regarding surgical options also resulted in increased decision uncertainty among trans women. Future controlled research should further explore optimizing information provision throughout the care process, managing uncertainties, and implementing the use of decision-aids by HCPs.
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