TY - JOUR
T1 - GenderJourney
T2 - Participatory development of an ethics support tool to foster dialogue and reflection on shared decision-making in gender-affirming medical care
AU - Gerritse, Karl
AU - Martens, Casper
AU - Bremmer, Marijke A.
AU - Kreukels, Baudewijntje P. C.
AU - de Vries, Annelou L. C.
AU - Molewijk, Bert C.
N1 - Funding Information: The Amsterdam Public Health Personalized Medicine Program supported this work. The funding agreement ensured the authors’ independence in designing the study, interpreting the data, and writing and publishing the report. Publisher Copyright: © 2023 The Authors
PY - 2023/9/1
Y1 - 2023/9/1
N2 - Objective: To describe and reflect on the development process of GenderJourney: an ethics support tool that seeks to foster (dialogue and reflection on) shared decision-making (SDM) in gender-affirming medical care (GAMC). Methods: Part of a larger project, this study used a participatory design. We included transgender and gender diverse (TGD) clients and healthcare professionals (HCPs) throughout the study in co-creation workshops. In an iterative process, we (1) established stakeholders’ needs, (2) reached a consensus on the aims, content, and design, (3) developed and tested successive renditions, and (4) presented the final version of the tool. Results: The final tool aims to (A) elucidate the client's care request and corresponding treatment preferences, (B) foster an explicit dialogue between TGD client and HCP about expected/preferred decisional roles and collaboration, (C) stimulate a systematic joint reflection on and handling of SDM-related ethical challenges. Conclusion: The GenderJourney provides non-directive ethics support to jointly reflect on and foster good SDM, including its inherent ethical challenges. Future studies should focus on its implementation and actual contribution to good SDM. Practice implications: GenderJourney may be used in GAMC to support the dialogue on what good SDM entails and the identification, discussion, and handling of SDM-related ethical challenges.
AB - Objective: To describe and reflect on the development process of GenderJourney: an ethics support tool that seeks to foster (dialogue and reflection on) shared decision-making (SDM) in gender-affirming medical care (GAMC). Methods: Part of a larger project, this study used a participatory design. We included transgender and gender diverse (TGD) clients and healthcare professionals (HCPs) throughout the study in co-creation workshops. In an iterative process, we (1) established stakeholders’ needs, (2) reached a consensus on the aims, content, and design, (3) developed and tested successive renditions, and (4) presented the final version of the tool. Results: The final tool aims to (A) elucidate the client's care request and corresponding treatment preferences, (B) foster an explicit dialogue between TGD client and HCP about expected/preferred decisional roles and collaboration, (C) stimulate a systematic joint reflection on and handling of SDM-related ethical challenges. Conclusion: The GenderJourney provides non-directive ethics support to jointly reflect on and foster good SDM, including its inherent ethical challenges. Future studies should focus on its implementation and actual contribution to good SDM. Practice implications: GenderJourney may be used in GAMC to support the dialogue on what good SDM entails and the identification, discussion, and handling of SDM-related ethical challenges.
KW - Clinical ethics support
KW - Communication aid
KW - Ethics support tool
KW - Gender incongruence
KW - Shared decision-making
KW - Transgender
KW - Working alliance
UR - http://www.scopus.com/inward/record.url?scp=85162982132&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.pec.2023.107854
DO - https://doi.org/10.1016/j.pec.2023.107854
M3 - Article
C2 - 37356115
SN - 0738-3991
VL - 114
JO - Patient Education and Counseling
JF - Patient Education and Counseling
M1 - 107854
ER -