Poceta Joanna, Cousins Stephanie, Wenzel Conrad, Lakhardt Kellyn, Hojilla Carlo, Marlowe Lisa, Ayoob Julie, Weintraub Miranda Ritterman, Zaritsky Eve F
The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Obstetrics and Gynecology, Kaiser Permanente Oakland Medical Center, Oakland, California, USA.
Int J Transgend. 2019 Mar 11;20(1):81-86. doi: 10.1080/15532739.2018.1528920. eCollection 2019.
Gender affirming surgeries are increasingly accessible to transgender and non-binary individuals due to changes in health care coverage policies and rising numbers of trained providers. Improved access to care has led to an increase in the number of individuals pursuing gender affirming surgeries. Little is known about how to optimally prepare patients for these surgeries. This evaluation examined attendees' assessment of a four-hour single-session class developed to prepare transgender and non-binary patients and their caregivers for gender affirming surgeries in a multi-disciplinary transgender clinic within an integrated health care system. A multi-disciplinary group of providers within a health maintenance organization in Northern California designed and facilitated two separate curricula, one for patients preparing for metoidioplasty/phalloplasty and the other preparing for vaginoplasty. Between November 2015 and June 2017, 214 patients and caregivers took one of the two versions of the class and completed the post-class survey evaluating perceived favorability of the class and preparedness regarding surgery options, complications and postoperative care. Descriptive statistics were used to summarize the Likert scale questions, with 1 showing the least improvement and 5 showing the most. Of the 214 patients and caregivers that completed the survey, the majority reported that they were better informed about their surgical options (mean: 4.4, SD: 0.7), more prepared for surgery (mean: 4.5, SD: 0.6), better informed about possible complications (mean: 4.5, SD: 0.7), and better understood their postoperative care needs (mean: 4.6, SD: 0.6). Of the respondents, 204 (95%) reported they would recommend the course to a friend preparing for gender affirming surgery. Our findings demonstrate that a single-session class is a favorable method for preparing transgender and non-binary patients to make informed decisions regarding the perioperative gender affirming surgical process, from preoperative preparedness, to surgical complications, and postoperative care.
由于医疗保健覆盖政策的变化以及经过培训的医疗服务提供者数量的增加，性别肯定手术对于跨性别者和非二元性别者来说越来越容易获得。获得医疗服务的改善导致寻求性别肯定手术的人数增加。对于如何最佳地让患者为这些手术做好准备，人们知之甚少。本评估研究了参与者对一个为期四小时的单节课程的评价，该课程旨在为跨性别者和非二元性别患者及其护理人员在综合医疗保健系统内的多学科跨性别诊所中进行性别肯定手术做好准备。北加利福尼亚州一个健康维护组织内的多学科医疗服务提供者团队设计并实施了两个单独的课程，一个针对准备做阴囊阴茎成形术/阴茎成形术的患者，另一个针对准备做阴道成形术的患者。在2015年11月至2017年6月期间，214名患者和护理人员参加了这两个版本课程中的一个，并完成了课后调查，评估对课程的感知好感度以及对手术选择、并发症和术后护理的准备情况。描述性统计用于总结李克特量表问题，1表示改善最少，5表示改善最多。在完成调查的214名患者和护理人员中，大多数人报告说他们对手术选择有了更充分的了解（平均值：4.4，标准差：0.7），对手术有了更充分的准备（平均值：4.5，标准差：0.6），对可能的并发症有了更充分的了解（平均值：4.5，标准差：0.7），并且对术后护理需求有了更好的理解（平均值：4.6，标准差：0.6）。在受访者中，204人（95%）报告说他们会向准备进行性别肯定手术的朋友推荐该课程。我们的研究结果表明，单节课程是一种很好的方法，可以让跨性别者和非二元性别患者在围手术期性别肯定手术过程中做出明智的决定，从术前准备到手术并发症以及术后护理。
