Decisional Regret Regarding Preoperative Fertility Preservation Choices After Gender-Affirming Surgery in Transgender Men/Gender Nonbinary Persons [ID 802]

INTRODUCTION: Investigate the prevalence of decisional regret (DR) regarding preoperative fertility preservation choices experienced by transgender/gender nonbinary (TGGNB) men/persons after gender-affirming surgery (GAS) or removal of reproductive of organs. METHODS: A single, cross-sectional online survey was conducted. Participants eligible for inclusion were those identifying as transgender male/gender nonbinary (based on use of personal pronouns and/or systemic gender-affirming medication) having undergone GAS or permanent sterilization with removal of reproductive organs (hysterectomy with bilateral salpingectomy and/or oophorectomy) at our academic institution between 2014 and 2023. Decisional regret was measured by the Decisional Regret Scale (DRS). RESULTS: One hundred thirteen participants met inclusion criteria and 57 participants completed the survey (response rate 50.4%). The median DRS score was 0 (interquartile range [IQR] 0–10; range 0–85). Approximately 1 in 3 (38.6%, n=22) participants reported DR regarding preoperative fertility preservation choices (mild regret 22.8% [n=13], severe regret 15.8% [n=9]). Patients who did not feel counseling was adequately discussed (16.1%, n=9) had significantly higher DRS scores than those who felt preoperative fertility counseling was adequately discussed (83.9%, n=47) (median DRS 50 [IQR 5–55] versus 0 [IQR 0–5], z=3.332, P =.001). CONCLUSIONS/IMPLICATIONS: This study represents one the first studies to report the prevalence of DR regarding fertility preservation choices among TGGNB persons specifically after GAS/removal of reproductive organs, highlighting the importance of comprehensive preoperative fertility counseling in order to provide patient-centered, gender-affirming care, reduce the risk of future DR, and provide equitable access to family-building options for the LGBTQI+ community.