SDM in Gender Affirming Surgery v.1.0

  • Research type

    Research Study

  • Full title

    Shared decision-making (SDM) in gender affirming surgery: a mixed methods, prospective outcome study

  • IRAS ID

    350507

  • Contact name

    Damon Foster

  • Contact email

    damon.foster2@nhs.net

  • Sponsor organisation

    Chelsea and Westminster Hospital NHS Foundation Trust

  • Duration of Study in the UK

    7 years, 0 months, 1 days

  • Research summary

    Gender affirming surgery (GAS) aims to align physical characteristics with gender identity. These interventions can be life-changing for trans+ and gender expansive (TGE) patients by reducing distress, known as gender dysphoria, reducing suicide risk, and improving overall well-being. Despite the evidence for the benefits of gender affirming care, and GAS specifically, many TGE individuals face barriers to accessing these services. Prejudices and misunderstandings about transgender identities contribute to poorer healthcare experiences and outcomes. In recent years, there has been a rise in scrutiny towards gender affirming care, including the robustness of the surgical decision-making process.

    Shared decision-making (SDM) is an approach aimed at empowering patients, particularly those from marginalised groups, to make informed choices about their healthcare. It encourages collaboration between healthcare providers and patients, focusing on the patient's values and preferences. Research shows that SDM can lead to better health outcomes, especially for long-term decisions, and both patients and healthcare providers often view it positively. Recent studies have begun to explore how SDM can work specifically in the context of gender affirming care, with benefits for patient outcomes, however, there is little research focusing on how SDM might be best achieved and how it might impact outcomes in gender affirming surgery, specifically.

    This study therefore aims to explore which factors are important to TGE patients in the surgical decision-making process, how patients and surgeons expect and experience their role in surgical decision-making and if this aligns, what impact SDM has on outcomes in GAS. Increasing understanding of the factors that underpin successful surgical decision-making in GAS can contribute to recommendations for best practice and improved outcomes for TGE patients.

  • REC name

    South Central - Oxford A Research Ethics Committee

  • REC reference

    26/SC/0138

  • Date of REC Opinion

    29 Apr 2026

  • REC opinion

    Favourable Opinion