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Assessing Patient Satisfaction Among Transgender Individuals Seeking Medical Services

Smith, Jesse R., MD, MS*; Washington, Arthur Zayne III, BA*; Morrison, Shane D., MD, MS; Gottlieb, Lawrence J., MD*

doi: 10.1097/SAP.0000000000001582
Review Papers

Background Gender dysphoria is estimated to occur in up to 0.4% of the US population. Gender-confirming surgery (GCS) has been shown to improve the quality of life of transgender patients. However, a dearth of standardized and reliable measures specific to transgender individuals exists to objectively gauge sensitivity and competency among providers caring for these patients.

Methods A comprehensive literature search of PubMed, MEDLINE, ISI Web of Science, and Cochrane databases using search terms related to provider competency and sensitivity during consultation for GCS was conducted for studies published through December 2017. Data were gathered from the publications that met inclusion criteria.

Results The total number of articles focusing on transgender persons was 14 of more than 75,000 patient satisfaction–oriented published articles (<0.001%). Only 8 (57%) of the 14 represented original research. After applying the inclusion criteria, only 2 were found to discuss measures of patient satisfaction specific to transgender individuals. Of these 2, none evaluated patient satisfaction specific to the time of surgical consultation.

Conclusions With increasing awareness and decreasing stigma surrounding transgender issues, it is likely that more transgender individuals will begin to seek GCS. There is a need for patient-reported experience measures specific to transgender individuals in order to appropriately gauge the interactions they experience with their surgeons. However, current instruments are neither standardized nor reliable for transgender patients to gauge provider sensitivity and competency.

From the *Section of Plastic and Reconstructive Surgery, Department of Surgery, The University of Chicago Medicine & Biological Sciences, Chicago, IL; and

Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, WA.

Received February 13, 2018, and accepted for publication, after revision June 7, 2018.

Conflicts of interest and sources of funding: Portions of this project were funded by a grant from the University of Chicago Medicine Biological Sciences Division's Office of Diversity & Inclusion. Funding was not received from the National Institutes of Health, Wellcome Trust, Howard Hughes Medical Institute, or RCUK.

All authors have substantial contributions to conception and design, acquisition of data, analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Reprints: Jesse R. Smith, MD, MS, Section of Plastic and Reconstructive Surgery, Department of Surgery, The University of Chicago Medicine & Biological Sciences, 5841 S Maryland Ave, Rm J-641 M/C 6035, Chicago, IL 60637. E-mail:

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