Cura Duygu Onur, Ülgenalp Ayfer, Çankaya Tufan
Department of Molecular Medicine, Institute of Health Sciences, Dokuz Eylül University, Izmir, Türkiye.
Department of Medical Genetics, Faculty of Medicine, Dokuz Eylül University, Izmir, Türkiye.
Brain Behav. 2025 Jan;15(1):e70228. doi: 10.1002/brb3.70228.
Genetic studies on the transgender and gender diverse (TGD) community have started to appear in the literature. However, there are limited studies on how genetic data will impact attitudes and perspectives toward TGD individuals. In this study, we investigated the impact of genetic alterations on physicians' attitudes toward TGD individuals and on physicians' decisions concerning gender confirmation surgery (GCS). In this context, we intended to highlight a number of strategies to reduce the inequalities that the TGD community is exposed to in accessing health-care services.
An online survey including the Turkish version of the Attitudes Toward Transgendered Individuals Scale (ATTIS) was completed by 224 physicians from relevant specialties. Scheffé and least significant difference (LSD) post hoc analysis methods were used to determine physicians' perspectives on whether genetic findings would cause TGD individuals to feel validated/invalidated. Multivariate multinomial logistic regression analysis was employed to assess their responses concerning the decision to perform GCS when genetic alterations had been identified.
More than half of the physicians expressed the view that genetic analyses for TGD individuals would confer benefits (67.1%). Those who thought that the presence of gender-diversity-related genetic alterations would have a "positive impact" on their GCS-related decision to operate were found to have less positive attitudes toward TGD individuals (Bonferroni corrected p < 0.001). Multivariate multinomial logistic regression analysis revealed that age, presenting the odds ratio as the strongest factor, distinguished the "no impact" group from the reference "positive impact" group, particularly among those aged ≤ 35 years (3.299, 95% CI: 1.355-8.033; p = 0.009).
Although genetic analysis of TGD individuals is predicted to have a positive effect on physicians' attitudes toward them and on the GCS decision-making process, it should be emphasized that the benefits for TGD individuals must outweigh the potential harm. The results showed that physicians need "early and continuing education" to develop a comprehensive perspective on gender identity. The most appropriate approach for genetic testing would be to include the TGD community in decision-making processes and to develop guidelines for the interpretation of genetic data.
关于跨性别和性别多样化（TGD）群体的基因研究已开始出现在文献中。然而，关于基因数据将如何影响对TGD个体的态度和观点的研究却很有限。在本研究中，我们调查了基因改变对医生对TGD个体的态度以及医生关于性别确认手术（GCS）决策的影响。在此背景下，我们旨在强调一些策略，以减少TGD群体在获得医疗服务时所面临的不平等。
来自相关专业的224名医生完成了一项在线调查，该调查包括土耳其语版的《对跨性别个体的态度量表》（ATTIS）。采用谢费检验和最小显著差异（LSD）事后分析方法来确定医生对于基因发现是否会使TGD个体感到被认可/不被认可的观点。当确定存在基因改变时，采用多变量多项逻辑回归分析来评估他们关于是否进行GCS决策的反应。
超过一半的医生表示，对TGD个体进行基因分析会带来益处（67.1%）。那些认为与性别多样性相关的基因改变的存在会对他们与GCS相关的手术决策产生“积极影响”的人，对TGD个体的态度不太积极（经邦费罗尼校正，p < 0.001）。多变量多项逻辑回归分析显示，年龄是区分“无影响”组与参考“积极影响”组的最强因素，其优势比表明，在年龄≤35岁的人群中尤为明显（3.299，95%置信区间：1.355 - 8.033；p = 0.009）。
尽管预计对TGD个体进行基因分析会对医生对他们的态度以及GCS决策过程产生积极影响，但应强调的是，对TGD个体的益处必须超过潜在危害。结果表明，医生需要“早期和持续教育”，以形成关于性别认同的全面观点。基因检测最合适的方法是让TGD群体参与决策过程，并制定基因数据解释指南。
