Austin Johnson M.D. , Asha B. McClurg M.D., M.S.C.R. , Janine Baldino M.D. , Rajeshree Das B.A. , Erin T. Carey M.D., M.S.C.R.
{"title":"变性男性/非二元性别者在接受性别确认手术后的生育力保存选择和决策遗憾","authors":"Austin Johnson M.D. , Asha B. McClurg M.D., M.S.C.R. , Janine Baldino M.D. , Rajeshree Das B.A. , Erin T. Carey M.D., M.S.C.R.","doi":"10.1016/j.xfre.2023.12.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the prevalence of decisional regret regarding preoperative fertility preservation choices after gender-affirming surgery or removal of reproductive organs.</p></div><div><h3>Design</h3><p>Cross-sectional.</p></div><div><h3>Setting</h3><p>University-based pratice.</p></div><div><h3>Patients</h3><p>A total of 57 survey respondents identifying as transgender men or gender nonbinary with a history of gender-affirming surgery or removal of reproductive organs between 2014 and 2023 with the University of North Carolina Minimally Invasive Gynecology division.</p></div><div><h3>Intervention</h3><p>Survey or questionnaire.</p></div><div><h3>Main Outcome Measures</h3><p>The prevalence and severity of decisional regret regarding preoperative fertility preservation choices were measured with the use of the validated decisional regret scale (DRS) (scored 0–100). Secondary outcomes included patient-reported barriers to pursuing reproductive endocrinology and infertility consultation and fertility preservation treatment.</p></div><div><h3>Results</h3><p>The survey response rate was 50.9% (57/112). “Mild” to “severe” decisional regret was reported by 38.6% (n = 22) of survey respondents, with DRS scores among all respondents ranging from 0–85. Higher median DRS scores were associated with patient-reported inadequacy of preoperative fertility counseling regarding implications of surgery on future fertility or family-building (0 vs. 50) and fertility preservation options (0 vs. 12.5). No desire for future fertility at the time of fertility counseling was the most frequent reason (68.4%) for declining a referral to reproductive endocrinology and infertility for additional fertility preservation discussion.</p></div><div><h3>Conclusions</h3><p>Decisional regret regarding preoperative fertility preservation choices is experienced among transgender men or gender nonbinary persons after gender-affirming surgery or the removal of reproductive organs. Preoperative, patient-centered fertility counseling and fertility preservation treatments should be provided to reduce the risk of future regret.</p></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 1","pages":"Pages 87-94"},"PeriodicalIF":0.0000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666334123001344/pdfft?md5=df43680816e9ca23df71ee2278096986&pid=1-s2.0-S2666334123001344-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Fertility preservation choices and decisional regret after gender-affirming surgery in transgender men or gender nonbinary persons\",\"authors\":\"Austin Johnson M.D. , Asha B. McClurg M.D., M.S.C.R. , Janine Baldino M.D. , Rajeshree Das B.A. , Erin T. Carey M.D., M.S.C.R.\",\"doi\":\"10.1016/j.xfre.2023.12.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To investigate the prevalence of decisional regret regarding preoperative fertility preservation choices after gender-affirming surgery or removal of reproductive organs.</p></div><div><h3>Design</h3><p>Cross-sectional.</p></div><div><h3>Setting</h3><p>University-based pratice.</p></div><div><h3>Patients</h3><p>A total of 57 survey respondents identifying as transgender men or gender nonbinary with a history of gender-affirming surgery or removal of reproductive organs between 2014 and 2023 with the University of North Carolina Minimally Invasive Gynecology division.</p></div><div><h3>Intervention</h3><p>Survey or questionnaire.</p></div><div><h3>Main Outcome Measures</h3><p>The prevalence and severity of decisional regret regarding preoperative fertility preservation choices were measured with the use of the validated decisional regret scale (DRS) (scored 0–100). Secondary outcomes included patient-reported barriers to pursuing reproductive endocrinology and infertility consultation and fertility preservation treatment.</p></div><div><h3>Results</h3><p>The survey response rate was 50.9% (57/112). “Mild” to “severe” decisional regret was reported by 38.6% (n = 22) of survey respondents, with DRS scores among all respondents ranging from 0–85. Higher median DRS scores were associated with patient-reported inadequacy of preoperative fertility counseling regarding implications of surgery on future fertility or family-building (0 vs. 50) and fertility preservation options (0 vs. 12.5). No desire for future fertility at the time of fertility counseling was the most frequent reason (68.4%) for declining a referral to reproductive endocrinology and infertility for additional fertility preservation discussion.</p></div><div><h3>Conclusions</h3><p>Decisional regret regarding preoperative fertility preservation choices is experienced among transgender men or gender nonbinary persons after gender-affirming surgery or the removal of reproductive organs. Preoperative, patient-centered fertility counseling and fertility preservation treatments should be provided to reduce the risk of future regret.</p></div>\",\"PeriodicalId\":34409,\"journal\":{\"name\":\"FS Reports\",\"volume\":\"5 1\",\"pages\":\"Pages 87-94\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2666334123001344/pdfft?md5=df43680816e9ca23df71ee2278096986&pid=1-s2.0-S2666334123001344-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"FS Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666334123001344\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"FS Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666334123001344","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目标调查性别确认手术或生殖器官切除术后对术前生育力保留选择的决定性后悔的普遍程度。患者在2014年至2023年期间在北卡罗来纳大学微创妇科接受过性别确认手术或生殖器官切除术的变性男性或性别非二元性调查对象共57人。干预措施调查或问卷调查。主要结果测量使用有效的决策后悔量表（DRS）（评分 0-100）测量术前生育力保留选择决策后悔的普遍性和严重程度。次要结果包括患者报告的进行生殖内分泌与不孕症咨询和生育力保存治疗的障碍。结果调查回复率为 50.9%（57/112）。38.6%（n = 22）的受访者报告了 "轻度 "至 "重度 "的决策后悔，所有受访者的 DRS 得分为 0-85 分。中位数 DRS 分数较高与患者报告的术前生育咨询不足有关，即手术对未来生育或建立家庭的影响（0 vs. 50）和生育力保存选择（0 vs. 12.5）。在接受生育咨询时对未来生育没有愿望是拒绝转诊到生殖内分泌和不孕不育科进行更多生育力保存讨论的最常见原因（68.4%）。结论 变性男性或性别非二元者在接受性别确认手术或切除生殖器官后，会对术前生育力保存选择感到后悔。应提供以患者为中心的术前生育咨询和生育力保存治疗，以降低未来后悔的风险。
Fertility preservation choices and decisional regret after gender-affirming surgery in transgender men or gender nonbinary persons
Objective
To investigate the prevalence of decisional regret regarding preoperative fertility preservation choices after gender-affirming surgery or removal of reproductive organs.
Design
Cross-sectional.
Setting
University-based pratice.
Patients
A total of 57 survey respondents identifying as transgender men or gender nonbinary with a history of gender-affirming surgery or removal of reproductive organs between 2014 and 2023 with the University of North Carolina Minimally Invasive Gynecology division.
Intervention
Survey or questionnaire.
Main Outcome Measures
The prevalence and severity of decisional regret regarding preoperative fertility preservation choices were measured with the use of the validated decisional regret scale (DRS) (scored 0–100). Secondary outcomes included patient-reported barriers to pursuing reproductive endocrinology and infertility consultation and fertility preservation treatment.
Results
The survey response rate was 50.9% (57/112). “Mild” to “severe” decisional regret was reported by 38.6% (n = 22) of survey respondents, with DRS scores among all respondents ranging from 0–85. Higher median DRS scores were associated with patient-reported inadequacy of preoperative fertility counseling regarding implications of surgery on future fertility or family-building (0 vs. 50) and fertility preservation options (0 vs. 12.5). No desire for future fertility at the time of fertility counseling was the most frequent reason (68.4%) for declining a referral to reproductive endocrinology and infertility for additional fertility preservation discussion.
Conclusions
Decisional regret regarding preoperative fertility preservation choices is experienced among transgender men or gender nonbinary persons after gender-affirming surgery or the removal of reproductive organs. Preoperative, patient-centered fertility counseling and fertility preservation treatments should be provided to reduce the risk of future regret.
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