Gender Affirming Care: Reducing Misinformation through Use of an Educational Toolkit for Patients

Background: Gender-affirming hormone therapy (if desired) is considered standard of practice for adolescents who are experiencing gender dysphoria. The University of Utah's Clinic A provides gender- affirming care for adolescents with gender dysphoria. The providers at Clinic A engage in extensive verbal education with the adolescents receiving care and their guardians at the clinic visit; however, they do not have written educational materials to reinforce their verbal information. This lack of written educational materials has been identified as a potential gap to implementing evidence-based education for the adolescents in their care. Local Problem: Clinic A is one of the few clinics that provides gender-affirming care for adolescents living in Utah. They provide treatment for the majority of adolescents in Utah who are experiencing gender-dysphoria, and occasionally provide care for adolescents from the surrounding states. Methods: A quality improvement project was developed to help providers implement hormone therapy education for patients. Providers at Clinic A were assessed for interest and feasibility of implementing an educational toolkit to assist with patient education. The toolkit included multiple handouts addressing the commonly discussed topics at Clinic A, including hormone therapy options, fertility preservation options, testosterone suppression options, sexual function issues, and standard procedures and expectations for first-time visits to what to Clinic A. These handouts were distributed at provider discretion, based on their assessment of patient interest and need. Post-implementation surveys were completed by providers to assess for feasibility, usability, and provider satisfaction with the toolkit. Results: The post-implementation usage data found that 70% of new patients at Clinic A had received a handout regarding hormone therapy options from the educational toolkit, and 48% had received a handout on fertility preservation. According to the post-implementation survey, all providers (100%, n = 4) reported they found the toolkit handouts to be very helpful, very applicable to their patient population, and very easy to use; all would very likely continue to use the toolkit handouts in their clinic. Conclusions: The educational toolkit handouts appear to be valuable resources to help providers at Clinic A implement evidence-based education for the adolescents receiving care at their clinic. Replication of 3 this quality improvement project, with feedback from the adolescent and guardian dyad, is needed to evaluate if the provider perceived benefits of the educational handouts carry across to the patient experience.