A metric treatment score as an alternative to predefined treatment stages - How to acknowledge individual treatment requests in research with trans individuals in need of transition related medical interventions

To date, the majority of research with trans individuals in need of transition -related medical interventions (TRMI) assumes a pre-defined clinical pathway, starting with mental health counseling and concluding with genital... [ view full abstract ]

To date, the majority of research with trans individuals in need of transition -related medical interventions (TRMI) assumes a pre-defined clinical pathway, starting with mental health counseling and concluding with genital reconstructive surgery (GRS). Therefore, previous research primarily investigated effects of hormonal treatment (White Hughto & Reisner, 2016) and GRS (Murad et al., 2010) on various mental health and quality of life outcomes. However, both empirical and clinical evidence suggests that individual intentions to undergo TRMI are more diverse than previously assumed (e.g. Beek et al, 2015; Eyssel et al., submitted). Some individuals only require few interventions to consider their transition complete, and therefore would be inconsistent with a predefined treatment path ending with GRS. The reasons for varying numbers of requested treatments per individual appear to be manifold. Besides non-binary gender identifications, poor aesthetic outcomes and a high risk of medical complications, especially in GRS, have been identified as important factors (Loos et al., 2016). Moreover, for some trans individuals, few TRMI might be sufficient to significantly reduce gender dysphoria and ensure an improvement in mental health and quality of life. This might be especially true for non-binary individuals.

Even though a majority of trans individuals in need of TRMI might require both hormonal treatment and genital surgery, a generalization of this understanding seems to be an inadequate reflection of the heterogeneous treatment... [ view full abstract ]

Even though a majority of trans individuals in need of TRMI might require both hormonal treatment and genital surgery, a generalization of this understanding seems to be an inadequate reflection of the heterogeneous treatment needs in the trans population.

Therefore, a newly developed metric score illustrating the individual treatment progress could be superior to the traditionally used pre-defined treatment phases. [ view full abstract ]

Therefore, a newly developed metric score illustrating the individual treatment progress could be superior to the traditionally used pre-defined treatment phases.

The individual treatment progress score (ITS) is calculated based on the number of undergone interventions standardized with the total number of planned interventions (already undergone interventions+ future interventions). [ view full abstract ]

The individual treatment progress score (ITS) is calculated based on the number of undergone interventions standardized with the total number of planned interventions (already undergone interventions+ future interventions).

The ITS has already been used in recent studies and achieved good results (Eyssel et al., submitted; Koehler et al., in prep.). It has been shown that the ITS explained a significant amount of variance and was superior to... [ view full abstract ]

The ITS has already been used in recent studies and achieved good results (Eyssel et al., submitted; Koehler et al., in prep.). It has been shown that the ITS explained a significant amount of variance and was superior to analysis based on predefined treatment stages.

Since the ITS does not assume a pre-defined end of TRMI, it opens up the possibility to examine individual requests with regard to transition-related care in a comparable way. As it does not need preconceptions of a... [ view full abstract ]

Since the ITS does not assume a pre-defined end of TRMI, it opens up the possibility to examine individual requests with regard to transition-related care in a comparable way. As it does not need preconceptions of a hypothetical treatment progress, the ITS provides additional information on the diversity of the sample and therefore might be more inclusive. To make the ITS more comprehensive, additional information (e.g. treatment satisfaction, aesthetical outcome) could be entered in the calculation.