Patient-centered outcomes on preparing for and undergoing gender-affirming phalloplasty: a qualitative, descriptive...

Area of Science:

• Medical research
• Qualitative health research
• Gender-affirming care

Background:

• Genital gender-affirming surgery (GGAS) incidence is rising.
• No standardized method exists to evaluate patient perspectives on GGAS.
• Patient-reported outcomes are essential for improving surgical care.

Purpose of the Study:

• To understand transgender and non-binary patient views on phalloplasty/metoidioplasty.
• To identify key themes in patient experiences.
• To inform the development of a patient-reported outcome measure for GGAS.

Main Methods:

• Systematic qualitative study utilizing thematic content analysis.
• Four virtual focus groups conducted with 18 patients (pre- and post-surgery).
• Data analyzed using deductive and inductive coding in ATLAS.ti software.

Main Results:

• Seven major themes and 19 subthemes were identified.
• Key themes included surgical goals, sexual and urinary function, peer support, decision-making, mental health, quality of life, and gender dysphoria.
• Patient priorities encompass functional, aesthetic, mental health, and quality of life outcomes.

Conclusions:

• Phalloplasty/metoidioplasty significantly impacts multiple life aspects for patients.
• Mental health, quality of life, and functional outcomes are critical patient considerations.
• Experiential aspects of surgery, alongside functional and aesthetic results, should be prioritized in outcome measures.