The Genital Surgery in Transmen decision aid (DA-GST) can help transmen assess their genital masculinization surgical options, a new Journal of Sexual Medicine study reports.
Larger studies are still needed, the researchers said. But the DA-GST “helped transmen feel more prepared for their personal consult with [their] surgeon, reduced [decisional conflict], and increased their decisional confidence.”
The DA-GST explains the various surgical possibilities along with the advantages and disadvantages of each type.
In this study, researchers investigated how well the DA-GST helped transmen make decisions about their care.
They worked with 51 transmen with an average age of 31 years. In the researchers’ clinic, patients seeking genital surgery consulted with a transgender healthcare team at least three times. The first visit was a group session, and the second was a private visit with a surgeon. At the third visit, patients made their final decisions regarding surgery and were added to the waiting list.
The participants completed questionnaires about their decision making at various time points. Overall, 99 questionnaires were submitted, and 15 transmen were interviewed.
Decision conflict was defined as “personal uncertainty about which course of action to take when choice among competing options involves risk, regret, or challenge to personal life values.” Regardless of whether participants were familiar with the DA-GST, decision conflict was higher in the earlier phases of the decision-making process (i.e., the group session).
Questionnaire results showed that in general, transmen found the DA-GST helpful for weighing pros and cons as well as preparing to discuss treatment goals with a doctor. Many participants indicated feeling confident and comfortable talking about their situation.
Transmen brought up several themes during the interviews:
- Getting information. Internet sources, including websites, videos, and online forums, were popular among the transmen. Talking to other transmen in person was also important, they said. “If you hear the actual experiences by others, that’s when you really get to understand the whole ‘human’ aspect of the surgery,” one 28-year-old participant remarked.
- Using the DA-GST. Most participants had done their own research before using the DA-GST, so the tool did not significantly affect their decision making process. Still, some referred back to it for guidance as they clarified their decisions. Others thought it would have been more useful if it were introduced earlier in the researching/decision-making process.
- Suggestions for improvement. Participants suggested including pictures of surgical outcomes and personal statements from transmen who had already undergone procedures.
The authors acknowledged several limitations. There was no baseline data, they said. In addition, it might have been difficult for the transmen to accurately recall their past experiences, as “the surgical track had been quite long.”
The study results could be helpful in developing a decision aid for transwomen, they added.
The Journal of Sexual Medicine
Mokken, Sterre E., BSc, et al.
“Evaluation of the Decision Aid for Genital Surgery in Transmen”
(Full-text. Published: August 1, 2020)