MaPGAS Decision Making

NCT ID: NCT06565663

Last Updated: 2025-11-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ENROLLING_BY_INVITATION

Clinical Phase

NA

Total Enrollment

140 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-10-23

Study Completion Date

2027-02-28

Brief Summary

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The goal of this clinical trial is to test a new online tool designed to provide clear and understandable information to help individuals considering Metoidioplasty and Phalloplasty Gender Affirming Surgery (MaPGAS)make informed decisions

The main questions it aims to answer are:

* How user-friendly is the decision aid for individuals considering metoidioplasty and phalloplasty?
* Does using the decision aid reduce uncertainty and improve readiness for making surgery decisions compared to usual care?

Participants in this study will:

* Be randomly assigned to either 1) receive usual care or 2) test the web-based decision aid.
* Share their feedback on the tool's usability and its helpfulness in supporting decision-making.
* Complete surveys before and after using the decision aid to measure any changes in their decision-making process.

Researchers will compare participants who used the decision aid with those who received standard care to see if the decision aid reduces decisional uncertainty and improves readiness for surgery.

Detailed Description

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This study aims to evaluate the usability, acceptability, and preliminary efficacy of a novel, web-based decision aid (DA) for Metoidioplasty and Phalloplasty Gender Affirming Surgeries (MaPGAS).

MaPGAS are increasingly performed to improve gender congruence and quality of life, however, patients face complex decisions which may impact fertility, urinary and sexual function. Existing decisional uncertainty among transgender and non-binary individuals considering MaPGAS highlights the need for effective decision support tools. Prior research indicates a gap in validated decision support, partly due to insufficient understanding of patient needs and a lack of published outcomes or guidelines. This study builds on preliminary work that identified key decision-making factors among patients and healthcare providers, leading to the development of a co-developed web-based MaPGAS picture DA prototype.

Cognitive interviews with both participants considering or post MaPGAS and healthcare providers will refine the decision tool. The study will also investigate the DA's implementation within clinical settings to understand optimal administration timing and its impact on shared decision-making processes.

This study will employ a mixed-methods approach and a prospective randomized controlled trial to assess the DA's usability and acceptability using the System Usability Scale and focus group feedback. Additionally, it aims to evaluate the DA's preliminary efficacy in reducing decisional conflict and improving decision readiness and shared decision-making quality compared to usual care. This will be measured using validated tools such as the Decisional Conflict Scale, Preparation for Decision Making Scale, and CollaboRATE measure, alongside semi-structured patient and provider interviews.

This research aims to addressing the decisional needs of transgender and non-binary individuals considering MaPGAS, aiming to empower them with the tools needed for making informed, value-congruent decisions regarding their surgical options.

Conditions

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Gender Dysphoria Gender Dysphoria, Adult Gender Incongruence Transgenderism Transsexualism Transgender Persons Phalloplasty

Keywords

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Gender-Affirming Surgery Sex Reassignment Surgery Gender Reassignment Surgery Phalloplasty Metoidioplasty Transmasculine FTM Gender Dysphoria Transgender Penile Reconstruction Female-to-Male Neophallus Transsexual Genital Reconstruction Reconstructive Urology

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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MaPGAS Decision Aid Intervention

Participants in this arm will be provided with access to a novel, web-based decision aid designed for individuals considering MaPGAS. The decision aid includes interactive components, educational materials regarding surgical options, risks, benefits, and patient testimonials. Participants will have unlimited access to the decision aid for four weeks prior to their surgical consultation.

Group Type EXPERIMENTAL

MaPGAS Decision Aid

Intervention Type BEHAVIORAL

This intervention involves a novel, web-based decision aid tool specifically designed to support transgender and non-binary individuals assigned female at birth in making informed decisions about Metoidioplasty and Phalloplasty Gender Affirming Surgeries (MaPGAS). The tool includes comprehensive information on surgical options, risks, benefits, and medical illustrations to aid in aligning surgical decisions with the individual's personal values and goals.

MaPGAS Usual Care

Participants in this arm will receive the standard pre-consultation care provided by their healthcare provider, which does not include access to the novel decision aid. Standard care may include informational brochures. This group serves to compare the outcomes of traditional decision-making processes with those who use the decision aid.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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MaPGAS Decision Aid

This intervention involves a novel, web-based decision aid tool specifically designed to support transgender and non-binary individuals assigned female at birth in making informed decisions about Metoidioplasty and Phalloplasty Gender Affirming Surgeries (MaPGAS). The tool includes comprehensive information on surgical options, risks, benefits, and medical illustrations to aid in aligning surgical decisions with the individual's personal values and goals.

Intervention Type BEHAVIORAL

Other Intervention Names

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Metoidioplasty and Phalloplasty Gender Affirming Surgery Web-Based Pictorial Decision Aid

Eligibility Criteria

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Inclusion Criteria

* Assigned female on the original birth certificate.
* Self-identifies as transgender male and/or gender non-binary.
* Able to speak, read, and understand English at a sixth-grade level.
* Aged 18 or older.
* Resides in the USA.
* For decision aid refinement: Considering metoidioplasty or phalloplasty, or is post-operative.
* For intervention and control arm: Has a consultation scheduled for metoidioplasty or phalloplasty.

Exclusion Criteria

* Participants involved in the initial tool refinement focus groups cannot participate in the intervention or control group to avoid contamination of the study outcomes.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University of Utah

OTHER

Sponsor Role collaborator

Dartmouth College

OTHER

Sponsor Role collaborator

National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

Dartmouth-Hitchcock Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Rachel A. Moses

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Rachel A. Moses, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Dartmouth-Hitchcock Clinic

Locations

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Dartmouth College

Hanover, New Hampshire, United States

Site Status

University of Utah

Salt Lake City, Utah, United States

Site Status

Countries

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United States

Other Identifiers

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1R01DK137994-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

STUDY02002174

Identifier Type: -

Identifier Source: org_study_id