Evidence map›Paper›PMID 42418773›Full record

ArticleThe British journal of surgery2026

Patient-reported outcomes in masculinizing gender-affirming chest surgery: validation of the GENDER-Q Chest scales.

Caleb Haley, Shane D Morrison, Manraj N Kaur, Charlene Rae, Megan Lane, Danny A Young-Afat, Tim C van de Grift, Nicola R Dean, Kathleen A Armstrong, Devin Coon and 29 more

Abstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

39 authors.

Caleb HaleySection of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0002-8453-0134
Shane D MorrisonDivision of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, Washington, USA.
Manraj N KaurPatient-Reported Outcomes, Value, & Experience Center (PROVE), Mass General Brigham, Harvard Medical School, Boston, Massachusetts, USA.
Charlene RaeDepartment of Pediatrics, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0003-4309-4636
Megan LaneSection of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Danny A Young-AfatDepartment of Plastic, Reconstructive, and Hand Surgery, Amsterdam University Medical Centre, Amsterdam, The Netherlands.
Tim C van de GriftDepartment of Plastic, Reconstructive, and Hand Surgery, Amsterdam University Medical Centre, Amsterdam, The Netherlands.ORCID 0000-0003-4382-7000
Nicola R DeanCollege of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.ORCID 0000-0001-7084-2359
Kathleen A ArmstrongDepartment of Surgery, Women's College Hospital, Toronto, Ontario, Canada.
Devin CoonDivision of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital, Mass General Brigham, Boston, Massachusetts, USA.
Zac A CannellTrans Health South Australia, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Christian X LavaDepartment of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington DC, USA.
Sylvie D CornacchiDepartment of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Alexis LaunganiPlastic Surgery Division, GrS Montréal, Montreal, Quebec, Canada.
Margriet G MullenderDepartment of Plastic, Reconstructive, and Hand Surgery, Amsterdam University Medical Centre, Amsterdam, The Netherlands.ORCID 0000-0001-6407-5405
Jens A SørensenResearch Unit for Plastic Surgery, University of Southern Denmark, Odense, Denmark.
Lotte PoulsenResearch Unit for Plastic Surgery, University of Southern Denmark, Odense, Denmark.ORCID 0000-0003-4205-806X
Jack G GraesserResearch Unit for Plastic Surgery, University of Southern Denmark, Odense, Denmark.
Thomas SatterwhiteAlign Surgical Associates Inc., San Francisco, California, USA.
Allison C HuAlign Surgical Associates Inc., San Francisco, California, USA.
Gerhard S MundingerCrane Center for Transgender Surgery, Austin, Texas, USA.
Hilliard T BrydgesDivision of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, Washington, USA.
Jessica J HsuSection of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Blair R PetersDivision of Plastic and Reconstructive Surgery, Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA.
Jens U BerliDivision of Plastic and Reconstructive Surgery, Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA.
Christodoulos KaoutzanisDivision of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.
Nargis KaliaDepartment of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.
Rachel Bluebond-LangnerHansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, New York, USA.
Oren GanorDepartment of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA.
Alireza Hamidian JahromiDepartment of Plastic and Reconstructive Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.
Bashar A HassanDepartment of Plastic and Reconstructive Surgery, Johns Hopkins Medicine, Baltimore, Maryland, USA.
Fan LiangDepartment of Plastic and Reconstructive Surgery, Johns Hopkins Medicine, Baltimore, Maryland, USA.
John H PangAlign Surgical Associates Inc., San Francisco, California, USA.
Edward C RayDepartment of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Gabriel A Del CorralDepartment of Plastic and Reconstructive Surgery, MedStar Franklin Square Medical Center, Baltimore, Maryland, USA.
Kenneth L FanDepartment of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington DC, USA.
Lily R MundyDepartment of Plastic and Reconstructive Surgery, Johns Hopkins Medicine, Baltimore, Maryland, USA.
Andrea L PusicDivision of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital, Mass General Brigham, Boston, Massachusetts, USA.
Anne F KlassenDepartment of Pediatrics, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0003-4720-0096

Funding

CIHR 167288
6 · The paper itself

Abstract

backgroundMasculinizing gender-affirming chest surgery is the most frequently accessed type of gender-affirming procedure. The GENDER-Q Chest scales were developed to better assess patient-reported outcomes in masculinizing gender-affirming chest surgery, yet previous psychometric assessment of these scales is limited. The aim of this study was to assess the construct validity of the GENDER-Q Chest scales (Chest, Nipples & Areolas, and Scars).

methodsAn international, cross-sectional study was performed to develop the GENDER-Q between February 2022 and March 2024. Individuals were included in this analysis if they had sought or received masculinizing gender-affirming chest surgery and completed the GENDER-Q Chest scale. Construct validity was assessed for each scale by testing a priori hypotheses. According to Consensus-based Standards for the Selection of Health Measurement Instruments guidelines, at least 75% acceptance of hypotheses indicates sufficient evidence of construct validity.

resultsA total of 2846 participants completed the GENDER-Q Chest scale. For the GENDER-Q Chest, Nipples & Areolas, and Scars scales, 95% (21 of 22), 79% (15 of 19), and 100% (12 of 12) of hypotheses were accepted for each scale respectively. Patients who had undergone surgery and did not need revisions at survey completion reported the highest satisfaction, while patients who had not yet undergone surgery reported the lowest satisfaction.

conclusionThe GENDER-Q Chest scales evidenced construct validity to measure appearance of chest, nipples and areolas, and scars for individuals seeking or undergoing masculinizing gender-affirming chest surgery. The GENDER-Q Chest scales provide a robust, validated approach for assessing outcomes in this context and are well suited for generating high-quality evidence on patient-reported outcomes.

Indexed as

Gender-Affirming SurgeryPatient Reported Outcome MeasuresThoracic Surgical ProceduresAdultCross-Sectional StudiesFemaleHumansMaleMiddle AgedPsychometricsYoung Adult

Identifiers

PMID42418773
PMCPMC13475804

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