PMID- 37037786 OWN - NLM STAT- MEDLINE DCOM- 20230602 LR - 20231007 IS - 1743-6109 (Electronic) IS - 1743-6095 (Linking) VI - 20 IP - 6 DP - 2023 May 26 TI - Desired decision-making role and treatment satisfaction among trans people during medical transition: results from the ENIGI follow-up study. PG - 893-904 LID - 10.1093/jsxmed/qdad039 [doi] AB - BACKGROUND: Shared decision making (SDM) is particularly important in transition-related medical interventions (TRMIs) given the nature of treatment and history of gatekeeping in transgender health care. Yet few studies have investigated trans people's desired decision-making role within TRMI and factors that influence these desires. AIMS: The study investigated trans people's desired level of decision making during medical transition as well as possible sociodemographic predictors and correlations between decision-making desires and satisfaction with treatment. METHODS: Data were collected from a clinical sample from 3 trans health care centers, as part of the larger ENIGI study. The data consisted of 568 trans individuals (60.2% assigned male at birth) 20 to 82 years of age (mean age = 38.58 years) who took part in the study 4 to 6 years after initial clinical contact. Binary logistic regressions were conducted to determine whether independent variables predicted group membership in decision-making role subgroups while a Spearman rank-order correlation was conducted to determine the relationship between desired decision-making involvement and satisfaction with care. OUTCOMES: Main measures were desired decision-making role, satisfaction with treatment, age, education level, country of residence, treatment status, individual treatment progress score (ITPS), gender identity, and sex assigned at birth. RESULTS: The vast majority of participants wanted to make medical decisions themselves. Age, education level, country of residence, treatment status, gender identity, and sex assigned at birth showed no significant effects in desired level of decision making, while the ITPS neared significance. Satisfaction with treatment was overall very high. For participants assigned male at birth, desire for a more active role in decision making was negatively correlated with satisfaction of labia surgery. CLINICAL IMPLICATIONS: A desired decision-making role cannot be predicted based on the trans person's sociodemographic characteristics. More involvement from health professionals addressing medical information and education obligations may be needed when offering surgical construction of labia to individuals assigned male at birth. STRENGTHS AND LIMITATIONS: This study builds on the few existing analyses of desired levels of decision-making role among trans people during transition. It is the first to investigate the role of education level and treatment status/ITPS on the desire of decision-making role. Gender identity and influence of nonbinary identity were not investigated for treatment satisfaction as these items were presented based on sex assigned at birth. CONCLUSION: This study highlights that trans people in 3 European trans health care centers during medical transition desire a more active role in decision making. Satisfaction with treatment received was overall very high. CI - (c) The Author(s) 2023. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. FAU - Mayer, Toby K AU - Mayer TK AD - Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany. FAU - Becker-Hebly, Inga AU - Becker-Hebly I AD - Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany. FAU - Elaut, Els AU - Elaut E AD - Department of Experimental, Clinical and Health Psychology, Ghent University, 9000 Ghent, Oost-Vlaanderen, Belgium. AD - Center of Sexology and Gender, University Hospital Ghent, 9000 Ghent, Oost-Vlaanderen, Belgium. FAU - Heylens, Gunter AU - Heylens G AD - Center of Sexology and Gender, University Hospital Ghent, 9000 Ghent, Oost-Vlaanderen, Belgium. FAU - Kreukels, Baudewijntje P C AU - Kreukels BPC AD - Department of Medical Psychology, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands. FAU - Nieder, Timo O AU - Nieder TO AD - Interdisciplinary Transgender Health Care Center Hamburg, Department for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany. LA - eng PT - Journal Article PL - Netherlands TA - J Sex Med JT - The journal of sexual medicine JID - 101230693 SB - IM CIN - J Sex Med. 2023 Oct 3;20(10):1258-1259. PMID: 37553086 CIN - J Sex Med. 2023 Oct 3;20(10):1261-1262. PMID: 37553087 MH - Infant, Newborn MH - Humans MH - Male MH - Female MH - Adult MH - Follow-Up Studies MH - *Gender Identity MH - *Transsexualism MH - Personal Satisfaction MH - Decision Making, Shared OTO - NOTNLM OT - health care OT - medical interventions OT - patient autonomy OT - patient satisfaction OT - shared decision making OT - transgender OT - transition EDAT- 2023/04/11 06:00 MHDA- 2023/06/02 06:42 CRDT- 2023/04/10 22:22 PHST- 2022/10/11 00:00 [received] PHST- 2023/01/29 00:00 [revised] PHST- 2023/03/01 00:00 [accepted] PHST- 2023/06/02 06:42 [medline] PHST- 2023/04/11 06:00 [pubmed] PHST- 2023/04/10 22:22 [entrez] AID - 7111528 [pii] AID - 10.1093/jsxmed/qdad039 [doi] PST - ppublish SO - J Sex Med. 2023 May 26;20(6):893-904. doi: 10.1093/jsxmed/qdad039.