Examining the Consent Process for Gender Affirming Care

Abstract: Informed consent may be considered medicine’s best homage to humanity, as it reminds us that each individual possesses unique thoughts and perspectives to be considered and explored before proceeding with care. Humans will always deserve a face-to-face discussion when deciding whether or not to pursue a potentially life-altering medical intervention, but how that occurs in clinical practice remains understudied, especially in the care of gender diverse youth.

As gender affirming medical treatments (GAMTs) are increasingly pursued by gender diverse youth, it is essential to investigate the efficacy of and satisfaction with the informed consent discussion between a provider and patient. Additionally, parental consent is required to receive this care, hence child-parent dyads must be in agreement to proceed. To better understand these perspectives, we constructed a cross sectional research study in which parent-child dyads complete an electronic survey. Questions focus on their attitudes and experiences with the informed consent discussion when initiating GAMTs. Preliminary analyses have demonstrated that both parents and youth are satisfied with the current informed consent practices, and find its education efforts to be efficacious. We’ve also concluded that fertility preservation practices have potential to be discussed in further detail. However, these conclusions are the results of a small ( < 10) sample size, suggesting our current analyses may change. Regardless, this data will allow us to tailor interventions aimed at improving the informed consent process (decision support tools, clinician training, educational materials, etc.) to the specific needs of gender diverse youth and their parents.

Julia Taylor, MD – Associate Professor, Department of Pediatrics, University of Virginia School of Medicine; Katherine Boguszewski – Clinical Research Coordinator, General Pediatrics, University of Virginia School of Medicine; Jessica Harris – Undergraduate Researcher, University of Virginia