The Gender Dissonance Severity Scale (GDSS): Development of a new questionnaire to evaluate treatment outcomes

Tailored treatment choices are vital for effective transgender healthcare. In order to improve transgender health services, gender confirming medical treatments need to be evaluated. Although tools that assess gender... [ view full abstract ]

Tailored treatment choices are vital for effective transgender healthcare. In order to improve transgender health services, gender confirming medical treatments need to be evaluated. Although tools that assess gender dysphoria, gender incongruence, body dissatisfaction, mental well-being and quality of life are available, there is currently no measure available that assesses these constructs simultaneously and has been developed specifically for, and in collaboration with, the transgender population. Such a measure is vital for effectively evaluating gender confirming medical treatments.

To design, in collaboration with the transgender population, a health outcome questionnaire. This measure will assess the severity of gender dissonance as well as associated mental well-being and general quality of life, at... [ view full abstract ]

To design, in collaboration with the transgender population, a health outcome questionnaire. This measure will assess the severity of gender dissonance as well as associated mental well-being and general quality of life, at different stages of the transitional process and is independent of gender assigned at birth.

First, an in-depth literature review was conducted to determine the limitations of the outcome measures that are currently available. Second, a qualitative study was conducted at a national transgender health service in the... [ view full abstract ]

First, an in-depth literature review was conducted to determine the limitations of the outcome measures that are currently available. Second, a qualitative study was conducted at a national transgender health service in the United Kingdom (UK). The finding from this study (and our knowledge of the literature) facilitated the first draft of the questionnaire. Third, the questionnaire was given to 25 transgender people on a patient advisory board at a national transgender health service in the UK for feedback. Finally, feedback was sought from 12 senior transgender healthcare clinicians (UK (n=10), Sweden (n=1) and Belgium (n=1)), which allowed us to develop a final draft.

Gender dissonance severity, associated mental well-being and quality of life.  [ view full abstract ]

Gender dissonance severity, associated mental well-being and quality of life. 

A questionnaire with 42 items was developed which aimed to assess the severity of gender dissonance, associated mental well-being and general quality of life, within the transgender population. Factor analysis revealed 7... [ view full abstract ]

A questionnaire with 42 items was developed which aimed to assess the severity of gender dissonance, associated mental well-being and general quality of life, within the transgender population. Factor analysis revealed 7 subscales (1. genitalia, 2. chest, 3. other secondary sex characteristics, 4. social gender role recognition, 5. physical and emotional intimacy, 6. psychological difficulties, and 7. life satisfaction). The GDSS was found to have good reliability and validity and is capable of distinguishing between groups of interest (e.g., cross-sex hormones vs. no cross-sex hormones). 

The GDSS is a robust measure that can be used to assess treatment outcomes within the transgender population. It is hoped that the measures will help clinicians make informed and tailored treatment choices in close... [ view full abstract ]

The GDSS is a robust measure that can be used to assess treatment outcomes within the transgender population. It is hoped that the measures will help clinicians make informed and tailored treatment choices in close collaboration with transgender patients and be able to effectivily evaluate the treatment offered. The challenges of developing the questionnaire will be discussed, and the final validated tool will be presented.