Investigating the outcome of the initial assessment at a national transgender health service: is it time to review the process?

Background: Globally there is a lack of a standardised assessment process prior to the initiation of gender affirming medical interventions and consequently there is a discrepancy in this process among different transgender health services. Aim: The main objective of this study is to investigate th...

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Main Authors: Jones, Bethany Alice, Brewin, Nicola, Richards, Christina, Van Eijk, Marnix, Stephenson-Allen, Alex, Arcelus, Jon
Format: Article
Published: Taylor & Francis 2017
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Online Access:https://eprints.nottingham.ac.uk/45146/
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author Jones, Bethany Alice
Brewin, Nicola
Richards, Christina
Van Eijk, Marnix
Stephenson-Allen, Alex
Arcelus, Jon
author_facet Jones, Bethany Alice
Brewin, Nicola
Richards, Christina
Van Eijk, Marnix
Stephenson-Allen, Alex
Arcelus, Jon
author_sort Jones, Bethany Alice
building Nottingham Research Data Repository
collection Online Access
description Background: Globally there is a lack of a standardised assessment process prior to the initiation of gender affirming medical interventions and consequently there is a discrepancy in this process among different transgender health services. Aim: The main objective of this study is to investigate the outcome of the initial assessment process at a national transgender health service. Method: The outcome of people over the age of 17 years, assessed at a large national transgender health service in the United Kingdom during a two year period was categorised into: 1) recommendation for cross-sex hormone treatment, or: 2) no recommendation for cross-sex hormone treatment. In addition, 200 case notes were reviewed in order to investigate the level of agreement between the two clinicians involved in the assessment process. Results: During the study period a total of 617 people completed their assessment at the service. Following assessment 380 (61.6%) patients were recommended for cross-sex hormone treatment, leaving 237 (38.4%) patients who required a longer assessment period or were discharged. The factors associated with being recommended for cross-sex hormone treatment were: having socially transitioned, not smoking, having initiated cross-sex hormones prior to assessment, being older, and assigned male at birth. Out of the 200 case notes reviewed, agreement between assessor 1 and 2 (3 months apart) was found in 88 % (n= 176) of the cases. Discussion: Although the results of the study may not be generalizable to other international centres, questioning the assessment process and the role of the assessors is important to ensure treatment is offered in a timely and efficient manner. The findings from this study suggest that the routine inclusion of two assessors needs to be reviewed.
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spelling nottingham-451462020-05-04T19:08:00Z https://eprints.nottingham.ac.uk/45146/ Investigating the outcome of the initial assessment at a national transgender health service: is it time to review the process? Jones, Bethany Alice Brewin, Nicola Richards, Christina Van Eijk, Marnix Stephenson-Allen, Alex Arcelus, Jon Background: Globally there is a lack of a standardised assessment process prior to the initiation of gender affirming medical interventions and consequently there is a discrepancy in this process among different transgender health services. Aim: The main objective of this study is to investigate the outcome of the initial assessment process at a national transgender health service. Method: The outcome of people over the age of 17 years, assessed at a large national transgender health service in the United Kingdom during a two year period was categorised into: 1) recommendation for cross-sex hormone treatment, or: 2) no recommendation for cross-sex hormone treatment. In addition, 200 case notes were reviewed in order to investigate the level of agreement between the two clinicians involved in the assessment process. Results: During the study period a total of 617 people completed their assessment at the service. Following assessment 380 (61.6%) patients were recommended for cross-sex hormone treatment, leaving 237 (38.4%) patients who required a longer assessment period or were discharged. The factors associated with being recommended for cross-sex hormone treatment were: having socially transitioned, not smoking, having initiated cross-sex hormones prior to assessment, being older, and assigned male at birth. Out of the 200 case notes reviewed, agreement between assessor 1 and 2 (3 months apart) was found in 88 % (n= 176) of the cases. Discussion: Although the results of the study may not be generalizable to other international centres, questioning the assessment process and the role of the assessors is important to ensure treatment is offered in a timely and efficient manner. The findings from this study suggest that the routine inclusion of two assessors needs to be reviewed. Taylor & Francis 2017-09-20 Article PeerReviewed Jones, Bethany Alice, Brewin, Nicola, Richards, Christina, Van Eijk, Marnix, Stephenson-Allen, Alex and Arcelus, Jon (2017) Investigating the outcome of the initial assessment at a national transgender health service: is it time to review the process? International Journal of Transgenderism, 18 (4). pp. 427-432. ISSN 1434-4599 Assessment Transgender Outcome hormones Transgender health services http://www.tandfonline.com/doi/abs/10.1080/15532739.2017.1372838 doi:10.1080/15532739.2017.1372838 doi:10.1080/15532739.2017.1372838
spellingShingle Assessment
Transgender
Outcome
hormones
Transgender health services
Jones, Bethany Alice
Brewin, Nicola
Richards, Christina
Van Eijk, Marnix
Stephenson-Allen, Alex
Arcelus, Jon
Investigating the outcome of the initial assessment at a national transgender health service: is it time to review the process?
title Investigating the outcome of the initial assessment at a national transgender health service: is it time to review the process?
title_full Investigating the outcome of the initial assessment at a national transgender health service: is it time to review the process?
title_fullStr Investigating the outcome of the initial assessment at a national transgender health service: is it time to review the process?
title_full_unstemmed Investigating the outcome of the initial assessment at a national transgender health service: is it time to review the process?
title_short Investigating the outcome of the initial assessment at a national transgender health service: is it time to review the process?
title_sort investigating the outcome of the initial assessment at a national transgender health service: is it time to review the process?
topic Assessment
Transgender
Outcome
hormones
Transgender health services
url https://eprints.nottingham.ac.uk/45146/
https://eprints.nottingham.ac.uk/45146/
https://eprints.nottingham.ac.uk/45146/