Skip to main content

Advertisement

SpringerLink
Log in

Community Engagement and Patient-Centered Implementation of Patient-Reported Outcome Measures (PROMs) in Gender Affirming Surgery: a Systematic Review

  • Male and Female Surgical Interventions (CC Carson III and JP Selph, Section Editors)
  • Published:
Current Sexual Health Reports Aims and scope Submit manuscript

Abstract

Purpose of review

Analyze the utilization of patient-centered outcomes research (PCOR) methods in the literature containing patient-reported outcome measures (PROMs) for gender affirming surgery (GAS).

Recent findings

Multiple recent systematic reviews have demonstrated that the majority of PROMs used to assess GAS are either ad hoc measures never intended for validation or are neither specific to nor validated for the population or intervention being studied. This review builds on prior works with inclusion of articles related to facial and vocal GAS and presentation of PCOR recommendations and best practices based on review findings.

Summary

A systematic review of records in PubMed and Scopus using search terms related to GAS and PROMs yielded 652 total articles of which 158 were included in the final analysis. Just over half of included articles utilized validated PROMs, though only 38% of those articles utilized a PROM that had been validated in the TGNB population. Thirteen (8.2%) studies detailed the involvement of patients in PROM development as subjects, and only 4 (2.5%) utilized PCOR methods that engaged TGNB individuals as research stakeholders. Utilization of PCOR methods in research evaluating outcomes of GAS is exceedingly rare despite increasing use of PROMs over time. To collect data that are both accurate and meaningful to the TGNB population, PCOR methods must be adopted within this field.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Availability of Data and Material

All material reviewed for this article is available within the academic publishing community.

Code Availability

See Appendix for final search strings utilized for review.

References

  1. Almazan AN, Keuroghlian AS. Association between gender-affirming surgeries and mental health outcomes. JAMA Surg. 2021;156(7):611–8.

    PubMed  PubMed Central  Google Scholar 

  2. Andréasson M, et al. Patient-reported outcome measures used in gender confirmation surgery: a systematic review. Plast Reconstr Surg. 2018;141(4):1026–39.

    PubMed  Google Scholar 

  3. Barone M, et al. A systematic review of patient-reported outcome measures following transsexual surgery. Aesthetic Plast Surg. 2017;41(3):700–13.

    CAS  PubMed  Google Scholar 

  4. Dy GW, et al. Patient reported outcome measures and quality of life assessment in genital gender confirming surgery. Transl Androl Urol. 2019;8(3):228–40.

    PubMed  PubMed Central  Google Scholar 

  5. Patient-Centered Outcomes Research Institute. 2021 [cited 2021; Available from: https://www.pcori.org/. Accessed May-July 2021.

  6. Agarwal CA, et al. Quality of life improvement after chest wall masculinization in female-to-male transgender patients: a prospective study using the BREAST-Q and Body Uneasiness Test. J Plast Reconstr Aesthet Surg. 2018;71(5):651–7.

    PubMed  Google Scholar 

  7. Hastings D, Markland C. Post-surgical adjustment of twenty-five transsexuals (male-to-female) in the university of Minnesota study. Arch Sex Behav. 1978;1978(7):327–36.

    Google Scholar 

  8. Sadoughi W, Jayaram B, Bush I. Postoperative changes in the self concept of transsexuals as measured by the Tennessee Self Concept Scale. Arch Sex Behav. 1978;7(4):347–9.

    CAS  PubMed  Google Scholar 

  9. Kuiper B, Cohen-Kettenis P. Sex reassignment surgery: a study of 141 Dutch transsexuals. Arch Sex Behav. 1988;17(5):439–56.

    CAS  PubMed  Google Scholar 

  10. Stein M, Tiefer L, Melman A. Followup observations of operated male-to-female transsexuals. J Urol. 1990;143(6):1188–92.

    CAS  PubMed  Google Scholar 

  11. van Noort DE, Nicolai JA. Comparison of two methods of vagina construction in transsexuals. Plast Reconstr Surg. 1993;91(7):1308–15.

    PubMed  Google Scholar 

  12. Tsoi WF. Follow-up study of transsexuals after sex-reassignment surgery. Singapore Med J. 1993;34(6):515–7.

    CAS  PubMed  Google Scholar 

  13. Tsoi WF, Kok LP, Yeo KL, Ratnam SS. Follow-up study of feamle transsexuals. Ann Acad Med. 1995;24(5):664.

    CAS  Google Scholar 

  14. Jarrar K, Wolff E, Weidner W. Long-term outcome of sex reassignment of male transsexual patients. Urologe. 1996;35(4):331–7.

    CAS  Google Scholar 

  15. Rakic Z, et al. The outcome of sex reassignment surgery in Belgrade: 32 Patients of both sexes. Arch Sex Behav. 1996;25(5):515–25.

    CAS  PubMed  Google Scholar 

  16. Khouri RK, Young VL, Casoli VM. Long-term results of total penile reconstruction with a prefabricated lateral arm free flap. J Urol. 1998;160(2):383–8.

    CAS  PubMed  Google Scholar 

  17. Rehman J, et al. The reported sex and surgery satisfactions of 28 postoperative male-to- female transsexual patients. Arch Sex Behav. 1999;28(1):71–89.

    CAS  PubMed  Google Scholar 

  18. Kanhai RCJ, Hage JJ, Mulder JW. Long-term outcome of augmentation mammaplasty in male-to-female transsexuals: a questionnaire survey of 107 patients. Br J Plast Surg. 2000;53(3):209–11.

    CAS  PubMed  Google Scholar 

  19. Krege S, Bex A, Lummen G, Rubben H. Male-to-female transsexualism: a technique, results and long-term follow-up in 66 patients. BJU Int. 2001;88(4):396–402.

    CAS  PubMed  Google Scholar 

  20. Papadopulos NA, Schaff J, Biemer E. Usefulness of free sensate Osteofasciocutaneous forearm and fibula flaps for neophallus construction. J Reconstr Microsurg. 2001;17(6):407–12.

    CAS  PubMed  Google Scholar 

  21. Yang CY, Palmer AD, Meltzer TR, Murray KD, Cohen JI. Cricothyroid approximation to elevate vocal pitch in male-to-female transsexuals: results of surgery. Ann Otol Rhinol Laryngol. 2002;111(6):477–85.

    PubMed  Google Scholar 

  22. Kim SK, Park JH, Lee KC, Park JM, Kim JT, Kim MC. Long-term results in patients after rectosigmoid vaginoplasty. Plast Reconstr Surg. 2003;112(1):143–51.

    Google Scholar 

  23. Liguori G, Trombetta C, Bucci S, Salame L, Bortul M, Siracusano S, Belgrano E. Laparoscopic mobilization of neovagina to assist secondary ileal vaginoplasty in male-to-female transsexuals. Urology. 2005;66(2):293–8.

    CAS  PubMed  Google Scholar 

  24. De Cuypere G, T’Sjoen G, Beerten R, Selvaggi G, De Sutter P, Hoebeke P, Monstrey S, Vansteenwegen A, Rubens R. Sexual and physical health after sex reassignment surgery. Arch Sex Behav. 2005;34:679–90.

    PubMed  Google Scholar 

  25. Revol M, Servant JM, Banzet P. Surgical treatment of male-to-female transsexuals: a ten-year experience assessment. Ann Chir Plast Esthet. 2006;51(6):499–511.

    CAS  PubMed  Google Scholar 

  26. Zimmermann A, et al. Transsexuals’ life satisfaction after gender transformation operations. Chirurg. 2006;77(5):432–8.

    CAS  PubMed  Google Scholar 

  27. Goddard JC, et al. Feminizing genitoplasty in adult transsexuals: early and long-term surgical results. BJU Int. 2007;100(3):607–13.

    PubMed  Google Scholar 

  28. Noureai SA, et al. The role of nasal feminization rhinoplasty in male-to-female gender reassignment. Arch Facial Plast Surg. 2007;9(5):318–20.

    PubMed  Google Scholar 

  29. Kuhn A, Hiltebrand R, Birkhäuser M. Do transsexuals have micturition disorders? Eur J Obstet Gynecol Reprod Biol. 2007;131(2):226–30.

    PubMed  Google Scholar 

  30. Leriche A, et al. Long-term outcome of forearm flee-flap phalloplasty in the treatment of transsexualism. BJU Int. 2008;101(10):1297–300.

    PubMed  Google Scholar 

  31. Monstrey S, et al. Chest-wall contouring surgery in female-to-male transsexuals: a new algorithm. Plast Reconstr Surg. 2008;121(3):849–59.

    CAS  PubMed  Google Scholar 

  32. Soli M, et al. Male to female gender reassignment: modified surgical technique for creating the neoclitoris and mons veneris. J Sex Med. 2008;5(1):210–6.

    PubMed  Google Scholar 

  33. Imbimbo C, et al. A report from a single institute’s 14-year experience in treatment of male-to-female transsexuals. J Sex Med. 2009;6(10):2736–45.

    PubMed  Google Scholar 

  34. Schaff J, Papadopulos NA. A new protocol for complete phalloplasty with free sensate and prelaminated osteofasciocutaneous flaps: experience in 37 patients. Microsurgery. 2009;29(5):413–9.

    PubMed  Google Scholar 

  35. Kuhn A, et al. Quality of life 15 years after sex reassignment surgery for transsexualism. Fertil Steril. 2009;92(5):1685-1689.e3.

    PubMed  Google Scholar 

  36. Koak I, et al. Laser reduction glottoplasty for managing androphonia after failed cricothyroid approximation surgery. J Voice. 2010;24(6):758–64.

    Google Scholar 

  37. Parola N, et al. Study of quality of life for transsexuals after hormonal and surgical reassignment. Sexologies. 2010;19(1):24–8.

    Google Scholar 

  38. Ainsworth TA, Spiegel JH. Quality of life of individuals with and without facial feminization surgery or gender reassignment surgery. Qual Life Res. 2010;19(7):1019–24.

    PubMed  Google Scholar 

  39. Morath S, Papadopulos N, Schaff J. Operative management and techniques of mastectomy in female-to-male transsexuals. Handchir Mikrochir Plast Chir. 2011;43(4):232–9.

    CAS  PubMed  Google Scholar 

  40. Djordjevic ML, Stanojevic DS, Bizic MR. Rectosigmoid vaginoplasty: clinical experience and outcomes in 86 cases. J Sex Med. 2011;8(12):3487–94.

    PubMed  Google Scholar 

  41. Kuhn A, Santi A, Birkhäuser M. Vaginal prolapse, pelvic floor function, and related symptoms 16 years after sex reassignment surgery in transsexuals. Fertil Steril. 2011;95(7):2379–82.

    PubMed  Google Scholar 

  42. Antoszewski B, et al. Long-term results of breast reduction in female-to-male transsexuals. Pol Przegl Chir. 2012;84(3):144–51.

    PubMed  Google Scholar 

  43. Berry MG, Curtis R, Davies D. Female-to-male transgender chest reconstruction: a large consecutive, single-surgeon experience. J Plast Reconstr Aesthet Surg. 2012;65(6):711–9.

    CAS  PubMed  Google Scholar 

  44. Salvador J, et al. Minimum 2-year follow up of sex reassignment surgery in Brazilian male-to-female transsexuals. Psychiatry Clin Neurosci. 2012;66(4):371–2.

    PubMed  Google Scholar 

  45. Motmans J, et al. Female and male transgender quality of life: socioeconomic and medical differences. J Sex Med. 2012;9(3):743–50.

    PubMed  Google Scholar 

  46. Amend B, et al. Surgical reconstruction for male-to-female sex reassignment. Eur Urol. 2013;64(1):141–9.

    PubMed  Google Scholar 

  47. Djordjevic ML, Bizic MR. Comparison of two different methods for urethral lengthening in female to male (metoidioplasty) surgery. J Sex Med. 2013;10(5):1431–8.

    PubMed  Google Scholar 

  48. Caenegem EV, Verhaeghe E, Tae Y, Wierckx K, Toye K, Goemaere S, Zmierczak H, Hoebeke P, Monstrey S, T’Sjoen G. Long-term evaluation of donor-site morbidity after radial forearm flap phalloplasty for transsexual men. J Sex Med. 2013;10(6):1644–51.

    PubMed  Google Scholar 

  49. Vasegh Rahimparvar F, et al. Comparison of quality of life in gender identity disorders after sex reassignment surgery with normal women in Tehran, Iran, 2012. Iran J Obstet Gynecol Infertility. 2013;16(74):10–9.

    Google Scholar 

  50. Weigert R, et al. Patient satisfaction with breasts and psychosocial, sexual, and physical well-being after breast augmentation in male-to-female transsexuals. Plast Reconstr Surg. 2013;132(6):1421–9.

    CAS  PubMed  Google Scholar 

  51. Terrier J, et al. Surgical outcomes and patients’ satisfaction with suprapubic phalloplasty. J Sex Med. 2014;11(1):288–98.

    PubMed  Google Scholar 

  52. Garcia MM, et al. Overall satisfaction, sexual function, and the durability of neophallus dimensions following staged female to male genital gender confirming surgery: the Institute of Urology, London U.K. experience. Transl Androl Urol. 2014;3(2):156–62.

    PubMed  PubMed Central  Google Scholar 

  53. Hess J, et al. Satisfaction with male-to-female gender reassignment surgery - results of a retrospective analysis. Deutsches Arzteblatt International. 2014;111(47):795–801.

    PubMed  PubMed Central  Google Scholar 

  54. Wierckx K, et al. Sexual desire in trans persons: associations with sex reassignment treatment. J Sex Med. 2014;11(1):107–18.

    PubMed  Google Scholar 

  55. de Vries AL, et al. Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics. 2014;134(4):696–704.

    PubMed  Google Scholar 

  56. Capitán L, et al. Facial feminization surgery: the forehead. Surgical techniques and analysis of results. Plast Reconstr Surg. 2014;134(4):609–19.

    PubMed  Google Scholar 

  57. Morrison SD, et al. Long-term outcomes of rectosigmoid neocolporrhaphy in male-to-female gender reassignment surgery. Plast Reconstr Surg. 2015;136(2):386–94.

    CAS  PubMed  Google Scholar 

  58. Wolter A, et al. Sexual reassignment surgery in female-to-male transsexuals: an algorithm for subcutaneous mastectomy. J Plast Reconstr Aesthet Surg. 2015;68(2):184–91.

    CAS  PubMed  Google Scholar 

  59. Karpel L, et al. Psychological and sexual well being of 207 transsexuals after sex reassignment in France. Ann Med Psychol. 2015;173(6):511–9.

    Google Scholar 

  60. Buncamper ME, et al. Aesthetic and functional outcomes of neovaginoplasty using penile skin in male-to-female transsexuals. J Sex Med. 2015;12(7):1626–34.

    PubMed  Google Scholar 

  61. Castellano E, et al. Quality of life and hormones after sex reassignment surgery. J Endocrinol Invest. 2015;38(12):1373–81.

    CAS  PubMed  Google Scholar 

  62. Reed HM, et al. Non-grafted vaginal depth augmentation for transgender atresia, our experience and survey of related procedures. Aesthetic Plast Surg. 2015;39(5):733–44.

    PubMed  Google Scholar 

  63. Geneid A, Rihkanen H, Kinnari TJ. Long-term outcome of endoscopic shortening and stiffening of the vocal folds to raise the pitch. Eur Arch Otorhinolaryngol. 2015;272(12):3751–6.

    PubMed  Google Scholar 

  64. Raffaini M, Magri AS, Agostini T. Full facial feminization surgery: patient satisfaction assessment based on 180 procedures involving 33 consecutive patients. Plast Reconstr Surg. 2016;137(2):438–48.

    CAS  PubMed  Google Scholar 

  65. da Silva DC, Schwarz K, Fontanari AMC, Costa AB, Massuda R, Henriques AA, Salvador J, Silveria E, Rosito TE, Lobato MIR. WHOQOL-100 before and after sex reassignment surgery in Brazilian male-to-female transsexual individuals. J Sex Med. 2016;2016(6):988–93.

    Google Scholar 

  66. van de Grift TC, et al. Body image in transmen: multidimensional measurement and the effects of mastectomy. J Sex Med. 2016;13(11):1778–86.

    PubMed  Google Scholar 

  67. van der Sluis WB, et al. Long-term follow-up of transgender women after secondary intestinal vaginoplasty. J Sex Med. 2016;13(4):702–10.

    PubMed  Google Scholar 

  68. Bouman MB, et al. Patient-reported esthetic and functional outcomes of primary total laparoscopic intestinal vaginoplasty in transgender women with penoscrotal hypoplasia. J Sex Med. 2016;13(9):1438–44.

    PubMed  Google Scholar 

  69. Bellinga RJ, et al. Technical and clinical considerations for facial feminization surgery with rhinoplasty and related procedures. JAMA Facial Plast Surg. 2017;19(3):175–81.

    PubMed  Google Scholar 

  70. Cárdenas-Camarena L, et al. Surgical masculinization of the breast: clinical classification and surgical procedures. Aesthetic Plast Surg. 2017;41(6):1477.

    PubMed  Google Scholar 

  71. Frederick MJ, Berhanu AE, Bartlett R. Chest surgery in female to male transgender individuals. Ann Plast Surg. 2017;78(3):249–53.

    CAS  PubMed  Google Scholar 

  72. Knox ADC, et al. A review of 101 consecutive subcutaneous mastectomies and male chest contouring using the concentric circular and free nipple graft techniques in female-to-male transgender patients. Plast Reconstr Surg. 2017;139(6):1260e–72e.

    CAS  PubMed  Google Scholar 

  73. Lo Russo G, Tanini S, Innocenti M. Masculine chest-wall contouring in FtM transgender: a personal approach. Aesthetic Plast Surg. 2017;41(2):369–74.

    PubMed  Google Scholar 

  74. Top H, Balta S. Transsexual mastectomy: selection of appropriate technique according to breast characteristics. Balkan Med J. 2017;34(2):147–55.

    PubMed  PubMed Central  Google Scholar 

  75. van de Grift TC, et al. Surgical indications and outcomes of mastectomy in transmen: a prospective study of technical and self-reported measures. Plast Reconstr Surg. 2017;140(3):415e–24e.

    PubMed  Google Scholar 

  76. van de Grift TC, et al. Effects of medical interventions on gender dysphoria and body image: a follow-up study. Psychosom Med. 2017;79(7):815–23.

    PubMed  PubMed Central  Google Scholar 

  77. Meister J, et al. Pitch elevation in male-to-female transgender persons-the Würzburg approach. J Voice. 2017;31(2):244.e7-244.e15.

    Google Scholar 

  78. Yılmaz T, et al. Anterior Glottic web formation for voice feminization: experience of 27 patients. J Voice. 2017;31(6):757–62.

    PubMed  Google Scholar 

  79. Buncamper ME, et al. Penile inversion vaginoplasty with or without additional full-thickness skin graft: to graft or not to graft? Plast Reconstr Surg. 2017;139(3):649e–56e.

    CAS  PubMed  Google Scholar 

  80. Lindqvist EK, et al. Quality of life improves early after gender reassignment surgery in transgender women. Eur J Plast Surg. 2017;40(3):223–6.

    PubMed  Google Scholar 

  81. Papadopulos NA, et al. Quality of life and patient satisfaction following male-to-female sex reassignment surgery. J Sex Med. 2017;14(5):721–30.

    PubMed  Google Scholar 

  82. Schwarz K, et al. Transsexual voice questionnaire for male-to-female Brazilian transsexual people. J Voice. 2017;31(1):120.e15-120.e20.

    Google Scholar 

  83. Casado JC, Rodríguez-Parra MJ, Adrián JA. Voice feminization in male-to-female transgendered clients after Wendler’s glottoplasty with vs. without voice therapy support. Eur Arch Otorhinolaryngol. 2017;274(4):2049–58.

    PubMed  Google Scholar 

  84. Falcone M, et al. Outcomes of inflatable penile prosthesis insertion in 247 patients completing female to male gender reassignment surgery. BJU Int. 2018;121(1):139–44.

    CAS  PubMed  Google Scholar 

  85. Jiang D, et al. Does depth matter? Factors affecting choice of vulvoplasty over vaginoplasty as gender-affirming genital surgery for transgender women. J Sex Med. 2018;15(6):902–6.

    PubMed  Google Scholar 

  86. Seyed-Forootan K, Karimi H, Seyed-Forootan NS. Autologous fibroblast-seeded amnion for reconstruction of neo-vagina in male-to-female reassignment surgery. Aesthetic Plast Surg. 2018;42(2):491–7.

    PubMed  Google Scholar 

  87. Wolter A, et al. Subcutaneous mastectomy in female-to-male transsexuals: optimizing perioperative and operative management in 8 years clinical experience. J Plast Reconstr Aesthet Surg. 2018;71(3):344–52.

    PubMed  Google Scholar 

  88. Zavlin D, et al. Male-to-female sex reassignment surgery using the combined vaginoplasty technique: satisfaction of transgender patients with aesthetic, functional, and sexual outcomes. Aesthetic Plast Surg. 2018;42(1):178–87.

    PubMed  Google Scholar 

  89. Özata Yildizhan B, Yuksel S, Avayu M, Noyan H, Yildizhan E. Effects of gender reassignment on quality of life and mental health in people with gender dysphoria. Turk Psikiyatri Dergisi. 2018;29(1). https://doi.org/10.5080/u18259

  90. Manrique OJ, et al. Gender-confirmation surgery using the pedicle transverse colon flap for vaginal reconstruction: a clinical outcome and sexual function evaluation study. Plast Reconstr Surg. 2018;141(3):767–71.

    CAS  PubMed  Google Scholar 

  91. Massie JP, et al. Predictors of patient satisfaction and postoperative complications in penile inversion vaginoplasty. Plast Reconstr Surg. 2018;141(6):911e–21e.

    CAS  PubMed  Google Scholar 

  92. Mora E, et al. Comparison of cricothyroid approximation and glottoplasty for surgical voice feminization in male-to-female transsexuals. Laryngoscope. 2018;128(9):2101–9.

    PubMed  Google Scholar 

  93. Yildizhan BO, Yuksel S, Avayu M, Noyan H, Yildizhan E. Effects of gender reassignment on quality of life and mental health in people with gender dysphoria. Turk J Psychiatry. 2017;29(1):1–10.

    Google Scholar 

  94. van de Grift TC, Elaut E, Cerwenka SC, Cohen-Kettenis PT. Surgical satisfaction, quality of life, and their association after gender-affirming surgery: a follow-up study. J Sex Marital Ther. 2018;44(2):138–48.

    PubMed  Google Scholar 

  95. Owen-Smith AA, et al. Association between gender confirmation treatments and perceived gender congruence, body image satisfaction, and mental health in a cohort of transgender individuals. J Sex Med. 2018;15(4):591–600.

    PubMed  PubMed Central  Google Scholar 

  96. van de Grift TC, Pigot GLS, Kreukels BPC, Bouman M, Mullender MG. Transmen’s experienced sexuality and genital gender-affirming surgery: findings from a clinical follow-up study. J Sex Marital Ther. 2019;45(3):201–5.

    PubMed  Google Scholar 

  97. Kaushik N, Jindal O, Bhardwaj DK. Sigma-lead male-to-female gender affirmation surgery: blending cosmesis with functionality. Plast Reconstr Surg Glob Open. 2019;7(4):e2169.

    PubMed  PubMed Central  Google Scholar 

  98. Manrique OJ, et al. Assessment of pelvic floor anatomy for male-to-female vaginoplasty and the role of physical therapy on functional and patient-reported outcomes. Ann Plast Surg. 2019;82(6):661–6.

    CAS  PubMed  Google Scholar 

  99. Boas SR, et al. Outcomes and predictors of revision labiaplasty and clitoroplasty after gender-affirming genital surgery. Plast Reconstr Surg. 2019;144(6):1451–61.

    CAS  PubMed  Google Scholar 

  100. La Padula S, et al. One-step facial feminization surgery: the importance of a custom-made preoperative planning and patient satisfaction assessment. J Plast Reconstr Aesthet Surg. 2019;72(10):1694–9.

    PubMed  Google Scholar 

  101. Neuville P, et al. First outcomes of the ZSI 475 FtM, a specific prosthesis designed for phalloplasty. J Sex Med. 2019;16(2):316–22.

    PubMed  Google Scholar 

  102. Raffaini M, et al. Evolution of full facial feminization surgery: creating the gendered face with an all-in-one procedure. J Craniofac Surg. 2019;30(5):1419–24.

    PubMed  Google Scholar 

  103. Akhoondinasab MR, et al. The comparison of a new durable coronaplasty technique with Norfolk method for glans reconstruction after phalloplasty. World J Plast Surg. 2020;9(1):39–43.

    PubMed  PubMed Central  Google Scholar 

  104. Coon D, et al. Breast augmentation in the transfemale patient: comprehensive principles for planning and obtaining ideal results. Plast Reconstr Surg. 2020;145(6):1343–53.

    CAS  PubMed  Google Scholar 

  105. de Blok CJM, et al. Frequency, determinants, and satisfaction of breast augmentation in trans women receiving hormone treatment. J Sex Med. 2020;17(2):342–8.

    PubMed  Google Scholar 

  106. Garcia MM, Shen W, Zhu R, Stettler I, Zaliznyak M, Barnajian M, Cohen J, Sarin A, Nasseri Y. Use of right colon vaginoplasty in gender affirming surgery: proposed advantages, review of technique, and outcomes. Surg Endosc. 2020;35:5643–54. https://doi.org/10.1007/s00464-020-08078.

    Article  PubMed  Google Scholar 

  107. Loree JT, et al. Transfeminine gender confirmation surgery with penile inversion vaginoplasty: an initial experience. Plast Reconstr Surg Glob Open. 2020;8(5):e2873.

    PubMed  PubMed Central  Google Scholar 

  108. van der Sluis WB, et al. Gender-confirming vulvoplasty in transgender women in the Netherlands: incidence, motivation analysis, and surgical outcomes. J Sex Med. 2020;17(8):1566–73.

    PubMed  Google Scholar 

  109. Stein MJ, et al. Surgical and patient-reported outcomes following double incision and free nipple grafting for female to male gender affirmation: does obesity make a difference? J Plast Reconstr Aesthet Surg. 2020;74(8):1743–51. https://doi.org/10.1016/j.bjps.2020.12.004.

    Article  PubMed  Google Scholar 

  110. Becker-Hebly I, Fahrenkrug A, Campion F, Richter-Appelt H, Schulte-Markwortt M, Barkmann C. Psychosocial health in adolescents and young adults with gender dysphoria before and after gender affirming medical interventions: a descriptive study from the Hamburg Gender Identity Service. Eur Child Adolesc Psychiatry. 2020;30:1755–67. https://doi.org/10.1007/s00787-020-01640-2.

    Article  PubMed  Google Scholar 

  111. Liedl B, et al. Gender affirmation female to male-metaidoioplasty. Urologe A. 2020;59(11):1331–9.

    CAS  PubMed  Google Scholar 

  112. Papadopulos NA, et al. Psychological pathologies and sexual orientation in transgender women undergoing gender confirming treatment. Ann Plast Surg. 2020;84(3):312–6.

    CAS  PubMed  Google Scholar 

  113. Tang CG. Evaluating patient benefit from laryngochondroplasty. Laryngoscope. 2020;130(Suppl 5):S1-s14.

    PubMed  Google Scholar 

  114. Bustos SS, et al. The nipple split sharing vs. conventional nipple graft technique in chest wall masculinization surgery: can we improve patient satisfaction and aesthetic outcomes? Aesthetic Plast Surg. 2020;44(5):1478–86.

    PubMed  Google Scholar 

  115. Brown SK, Chang J, Hu S, Sivakumar G, Sataluri M, Goldberg L, Courey MS. Addition of Wendler Glottoplasty to voice therapy improves trans female voice outcomes. Laryngoscope. 2020;131(7):1588–93. https://doi.org/10.1002/lary.29050.

    Article  PubMed  Google Scholar 

  116. Daurade M, Brosset S, Chauvel-Picard J, Sigaux N, Mojallal A, Boucher F. Trans-oral versus cervicofacial lift approach for mandibular angle resection in facial feminization: a retrospective study. J Stomatol Oral Maxillofac Surg. 2021. https://doi.org/10.1016/j.jormas.2021.03.006.

    Article  PubMed  Google Scholar 

  117. Neuville P, et al. Metoidioplasty with implantation of a specific semirigid prosthesis. J Sex Med. 2021;18(4):830–6.

    PubMed  Google Scholar 

  118. Decuypere F, De Wolf E, Vyncke T, Claes K, Monstrey S, Buncamper M. Male-to-female gender affirmation surgery: breast reconstruction with Ergonomix round prostheses. Int J Impot Res. 2021;33:720–5. https://doi.org/10.1038/s41443-021-00425-8.

    Article  Google Scholar 

  119. Nieder TO, et al. Individual treatment progress predicts satisfaction with transition-related care for youth with gender dysphoria: a prospective clinical cohort study. J Sex Med. 2021;18(3):632–45.

    CAS  PubMed  Google Scholar 

  120. Robinson IS, et al. Surgical outcomes following gender affirming penile reconstruction: patient-reported outcomes from a multi-center, International Survey of 129 Transmasculine Patients. J Sex Med. 2021;18(4):800–11.

    PubMed  Google Scholar 

  121. Lawrence AA. Patient-reported complications and functional outcomes of male-to-female sex reassignment surgery. Arch Sex Behav. 2006;35(6):717–27.

    PubMed  Google Scholar 

  122. Lobato MI, et al. Follow-up of sex reassignment surgery in transsexuals: a Brazilian cohort. Arch Sex Behav. 2006;35(6):711–5.

    PubMed  Google Scholar 

  123. Nelson L, Whallett EJ, McGregor JC. Transgender patient satisfaction following reduction mammaplasty. J Plast Reconstr Aesthet Surg. 2009;62(3):331–4.

    CAS  PubMed  Google Scholar 

  124. Weyers S, et al. Long-term assessment of the physical, mental, and sexual health among transsexual women. J Sex Med. 2009;6(3):752–60.

    PubMed  Google Scholar 

  125. Wierckx K, et al. Quality of life and sexual health after sex reassignment surgery in transsexual men. J Sex Med. 2011;8(12):3379–88.

    PubMed  Google Scholar 

  126. Vukadinovic V, et al. The role of clitoral anatomy in female to male sex reassignment surgery. Sci World J. 2014;2014:437378.

    Google Scholar 

  127. Jokić-Begić N, Lauri Korajlija A, Jurin T. Psychosocial adjustment to sex reassignment surgery: a qualitative examination and personal experiences of six transsexual persons in croatia. Sci World J. 2014;2014:960745.

    Google Scholar 

  128. Meister J, et al. Patient satisfaction after pitch elevation and development of a therapy algorithm. Laryngorhinootologie. 2016;95(11):774–82.

    CAS  PubMed  Google Scholar 

  129. Silva Herrera JM, et al. Quality of life, lower urinary tract function and sexual health after sex reassignment surgery in male to female transexuals. Urologia Colombiana. 2016;25(2):81–7.

    Google Scholar 

  130. Casado JC, et al. Wendler glottoplasty and voice-therapy in male-to-female transsexuals: results in pre and post-surgery assessment. Acta Otorrinolaringol Esp. 2016;67(2):83–92.

    PubMed  Google Scholar 

  131. van de Grift TC, Pigot GLS, Boudhan S, Elfering L, Kreukels BPC, Gijs LACL, Buncamper ME, Ozer M, van der Sluis W, Meuleman EJH, Bouman M, Mullender MG. A longitudinal study of motivations before and psychosexual outcomes after genital gender-confirming surgery in transmen. J Sex Med. 2017;14(12):1621–8.

    PubMed  Google Scholar 

  132. Bertrand B, et al. Female-to-male transgender chest reconstruction: a retrospective study of patient satisfaction. Ann Chir Plast Esthet. 2017;62(4):303–7.

    CAS  PubMed  Google Scholar 

  133. LeBreton M, et al. Genital sensory detection thresholds and patient satisfaction with vaginoplasty in male-to-female transgender women. J Sex Med. 2017;14(2):274–81.

    PubMed  Google Scholar 

  134. Papadopulos NA, et al. Male-to-female sex reassignment surgery using the combined technique leads to increased quality of life in a prospective study. Plast Reconstr Surg. 2017;140(2):286–94.

    CAS  PubMed  Google Scholar 

  135. Sigurjónsson H, et al. Long-term sensitivity and patient-reported functionality of the neoclitoris after gender reassignment surgery. J Sex Med. 2017;14(2):269–73.

    PubMed  Google Scholar 

  136. El-Hadi H, et al. Gender-affirming surgery for transgender individuals: perceived satisfaction and barriers to care. Plast Surg (Oakv). 2018;26(4):263–8.

    Google Scholar 

  137. van de Grift TC, Elfering L, Greijdanus M, Smit JM, Bouman M, Klassen AF, Mullender MG. Subcutaneous mastectomy improves satisfaction with body and psychosocial function in trans men: findings of a cross-sectional study using the BODY-Q chest module. Plast Reconstr Surg. 2018;142(5):1125–32.

    PubMed  PubMed Central  Google Scholar 

  138. Simbar M, et al. Quality of life and body image of individuals with gender dysphoria. J Sex Marital Ther. 2018;44(6):523–32.

    PubMed  Google Scholar 

  139. Olson-Kennedy J, et al. Chest reconstruction and chest dysphoria in transmasculine minors and young adults: comparisons of nonsurgical and postsurgical cohorts. JAMA Pediatr. 2018;172(5):431–6.

    PubMed  PubMed Central  Google Scholar 

  140. Jellestad L, et al. Quality of life in transitioned trans persons: a retrospective cross-sectional cohort study. Biomed Res Int. 2018;2018:8684625.

    PubMed  PubMed Central  Google Scholar 

  141. Miller TJ, et al. Breast augmentation in male-to-female transgender patients: Technical considerations and outcomes. JPRAS Open. 2019;21:63–74.

    PubMed  PubMed Central  Google Scholar 

  142. Morselli PG, et al. Chest wall masculinization in female-to-male transsexuals: our treatment algorithm and life satisfaction questionnaire. Ann Plast Surg. 2019;83(6):629–35.

    CAS  PubMed  Google Scholar 

  143. di Summa PG, et al. Colic-based transplant in sexual reassignment surgery: functional outcomes and complications in 43 consecutive patients. J Sex Med. 2019;16(12):2030–7.

    PubMed  Google Scholar 

  144. Elfering L, et al. Preexpansion in phalloplasty patients: is it effective? Ann Plast Surg. 2019;83(6):687–92.

    CAS  PubMed  Google Scholar 

  145. Naeimi S, et al. Quality of life changes in Iranian patients undergoing female-to-male transsexual surgery: a prospective study. Arch Iran Med. 2019;22(2):71–5.

    PubMed  Google Scholar 

  146. Breidenstein A, et al. Psychosocial resources and quality of life in transgender women following gender-affirming surgery. J Sex Med. 2019;16(10):1672–80.

    PubMed  Google Scholar 

  147. Poudrier G, et al. Assessing quality of life and patient-reported satisfaction with masculinizing top surgery: a mixed-methods descriptive survey study. Plast Reconstr Surg. 2019;143(1):272–9.

    CAS  PubMed  Google Scholar 

  148. Ayyala HS, et al. A three-step technique for optimal nipple position in transgender chest masculinization. Aesthet Surg J. 2020;40(11):Np619-np625.

    PubMed  Google Scholar 

  149. Khafif A, et al. Scarless neck feminization: transoral transvestibular approach chondrolaryngoplasty. Facial Plast Surg Aesthet Med. 2020;22(3):172–80.

    PubMed  Google Scholar 

  150. Pigot GLS, et al. Genital gender-affirming surgery without urethral lengthening in transgender men-a clinical follow-up study on the surgical and urological outcomes and patient satisfaction. J Sex Med. 2020;17(12):2478–87.

    PubMed  Google Scholar 

  151. Morrison SD, et al. Prospective quality-of-life outcomes after facial feminization surgery: an international multicenter study. Plast Reconstr Surg. 2020;145(6):1499–509.

    CAS  PubMed  Google Scholar 

  152. Küenzlen L, et al. Multimodal evaluation of functional nerve regeneration in transgender individuals after phalloplasty with a free radial forearm flap. J Sex Med. 2020;17(5):1012–24.

    PubMed  Google Scholar 

  153. Vedovo F, et al. Operated male-to-female sexual function index: validity of the first questionnaire developed to assess sexual function after male-to-female gender affirming surgery. J Urol. 2020;204(1):115–20.

    PubMed  Google Scholar 

  154. de Rooij FPW, van de Grift TC, Veerman H, Al-Tamimi M, van der Sluis WB, Ronkes BL, Ozer M, Mullender MG, Bouman M, Pigot GLS. Patient-reported outcomes after genital gender-affirming surgery with versus without urethral lengthening in transgender men. J Sex Med. 2021;18(5):974–81.

    PubMed  Google Scholar 

  155. Papadopulos NA, Benjamin E, Zavlin D, Lelle J, Henrich G, Kovacs L, Herschbach P, Machens H, Scaff J. Quality of life and satisfaction in transgender men after phalloplasty in a retrospective study. Ann Plast Surg. 2021;87(1):91–7. https://doi.org/10.1097/SAP.0000000000002693.

    Article  CAS  PubMed  Google Scholar 

  156. Alcon A, et al. Quantifying the psychosocial benefits of masculinizing mastectomy in trans male patients with patient-reported outcomes: the University of California, San Francisco, gender quality of life survey. Plast Reconstr Surg. 2021;147(5):731e–40e.

    CAS  PubMed  Google Scholar 

  157. Berg JEA, Gustafsson M. Long-term follow up after sex reassignment surgery. Scand J Plast Reconstr Surg Hand Surg. 1997;31(1):39–45.

    PubMed  Google Scholar 

  158. Rehman J, Melman A. Formation of neoclitoris from glans penis by reduction glansplasty with preservation of neurovascular bundle in male-to-female gender surgery: functional and cosmetic outcome. J Urol. 1999;161(1):200–6.

    CAS  PubMed  Google Scholar 

  159. Matai V, Cheesman AD, Clarke PM. Cricothyroid approximation and thyroid chondroplasty: a patient survey. Otolaryngol-Head Neck Surg. 2003;128(6):841–7.

    PubMed  Google Scholar 

  160. Cysarz D, et al. Changes in body image satisfaction, sense of coherence and life satisfaction during the therapy of women with transsexualism. A preliminary report. Psychiatr Pol. 2008;42(1):115–23.

    PubMed  Google Scholar 

  161. Costantino A, et al. A prospective study on sexual function and mood in female-to-male transsexuals during testosterone administration and after sex reassignment surgery. J Sex Marital Ther. 2013;39(4):321–35.

    PubMed  Google Scholar 

  162. Hunt DD, Hampson JL. Follow-up of 17 biologic male transsexuals after sex-reassignment surgery. Am J Psychiatry. 1980;137(4):432–8.

    CAS  PubMed  Google Scholar 

  163. van der Sluis WB, et al. Long-term follow-up of transgender women after secondary intestinal vaginoplasty. J Sex Med. 2016;13(4):702–10.

    PubMed  Google Scholar 

  164. van de Grift TC, Kreukels BPC, Elfering L, Ozer M, Bouman M, Buncamper ME, Smit JM, Mullender MG. Body image in transmen: multidimensional measurement and the effects of mastectomy. J Sex Med. 2016;13(11):1778–86.

    PubMed  Google Scholar 

  165. Lawrence AA. Factors associated with satisfaction or regret following male-to-female sex reassignment surgery. Arch Sex Behav. 2003;32:299–315.

    PubMed  Google Scholar 

  166. Chang EM, Gillespie EF, Shaverdian N. Truthfulness in patient-reported outcomes: factors affecting patients’ responses and impact on data quality. Patient Relat Outcome Meas. 2019;10:171–86.

    PubMed  PubMed Central  Google Scholar 

  167. Quinn VP, et al. Cohort profile: Study of Transition, Outcomes and Gender (STRONG) to assess health status of transgender people. BMJ Open. 2017;7(12):e018121.

    PubMed  PubMed Central  Google Scholar 

  168. Owen-Smith AA, Woodyatt C, Sineath CR, Hunkeler EM, Barnwell La T, Graham A, Stephenson R, Goodman M. Perceptions of barriers to and facilitators of participation in health research among transgender people. Transgender Health 2016;1(1). https://doi.org/10.1089/trgh.2016.0023

  169. Stone S. The empire strikes back: a posttranssexual manifesto, in The Transgender Studies Reader, S.W. Susan Stryker, Editor. 2006, Routledge: New York.

  170. IV, DS. Mutilating gender, in The Transgender Studies Reader, S.W. Susan Stryker & S Whittle, Editors. 2006, Taylor & Francis: New York

  171. Petersen ME, Dickey R. Surgical sex reassignment: a comparative survey of International centers. Arch Sex Behav. 1995;24(2):135–56.

    CAS  PubMed  Google Scholar 

  172. Hood K, et al. Mode of data elicitation, acquisition and response to surveys: a systematic review. Health Technol Assess (Winchester, England). 2012;16(27):1–162.

    CAS  Google Scholar 

  173. Turner CF, et al. Adolescent sexual behavior, drug use, and violence: increased reporting with computer survey technology. Science. 1998;280(5365):867–73.

    CAS  PubMed  Google Scholar 

  174. Winter S, et al. Transgender people: health at the margins of society. The Lancet. 2016;388(10042):390–400.

    Google Scholar 

  175. Rowe D, Ng YC, O’Keefe LC. Addressing transgender patients’ barriers to access care. Nurse Pract. 2019;44(6):30–8.

    PubMed  Google Scholar 

  176. Howard SD, et al. Healthcare experiences of transgender people of color. J Gen Intern Med. 2019;34(10):2068–74.

    PubMed  PubMed Central  Google Scholar 

  177. Davis RE, Couper MP, Janz NK, Caldwell CH, Resnicow K. Interviewer effects in public health surveys. Health Educ Res. 2010;25(1):14–26.

    CAS  PubMed  Google Scholar 

  178. Brett J, et al. Mapping the impact of patient and public involvement on health and social care research: a systematic review. Health Expect. 2014;17(5):637–50.

    PubMed  Google Scholar 

  179. Morain SR, et al. Deliberative engagement methods for patient-centered outcomes research. The Patient - Patient-Centered Outcomes Research. 2017;10(5):545–52.

    PubMed  Google Scholar 

  180. Haynes SC, et al. Engaging stakeholders to develop a patient-centered research agenda: lessons learned from the Research Action for Health Network (REACHnet). Med Care. 2018;56 Suppl 10 Suppl 1(10 Suppl 1):S27–32.

    PubMed  Google Scholar 

  181. Gore JL. Incorporating the patient into urologic cancer research. Urol Oncol. 2017;35(9):546–7.

    PubMed  Google Scholar 

  182. De Las Nueces D, et al. A systematic review of community-based participatory research to enhance clinical trials in racial and ethnic minority groups. Health Serv Res. 2012;47(3pt2):1363–86.

    PubMed Central  Google Scholar 

  183. Nápoles AM, Santoyo-Olsson J, Stewart AL. Methods for translating evidence-based behavioral interventions for health-disparity communities. Prev Chronic Dis. 2013;10:E193–E193.

    PubMed  PubMed Central  Google Scholar 

  184. Dudley L, et al. What difference does patient and public involvement make and what are its pathways to impact? Qualitative Study of Patients and Researchers from a Cohort of Randomised Clinical Trials. PLOS ONE. 2015;10(6):e0128817.

    PubMed  PubMed Central  Google Scholar 

  185. Sheridan S, et al. The PCORI engagement rubric: promising practices for partnering in research. Ann Fam Med. 2017;15(2):165–70.

    PubMed  PubMed Central  Google Scholar 

  186. Klassen AF, et al. International phase I study protocol to develop a patient-reported outcome measure for adolescents and adults receiving gender-affirming treatments (the GENDER-Q). BMJ Open. 2018;8(10):e025435.

    PubMed  PubMed Central  Google Scholar 

Download references

Funding

This project was partially funded through a Patient-Centered Outcomes Research Institute® (PCORI®) Eugene Washington PCORI Engagement Award (EA-18835).

Author information

Authors and Affiliations

  1. Department of Urology, Oregon Health and Science University, 3181 SW Sam Jackson Parkway Rd, Portland, OR, 97239, USA

    Emily K. Clennon, Leigh H. Martin, Craig Sineath & Geolani W. Dy

  2. Department of Surgery, Kaiser Permanente, Bellevue, WA, USA

    Sarah K. Fadich

  3. Library, Oregon Health and Science University, Portland, OR, USA

    Laura Zeigen

  4. Department of Urology, New York University Langone Health, New York, NY, USA

    Gaines Blasdel

Authors
  1. Emily K. Clennon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Leigh H. Martin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sarah K. Fadich
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Laura Zeigen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gaines Blasdel
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Craig Sineath
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Geolani W. Dy
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Study Conception and Design: Geolani Dy, Emily Clennon.

Article Collection: Emily Clennon, Laura Zeigen.

Article Screening: Emily Clennon, Leigh Martin.

Full Text Analysis: Emily Clennon, Leigh Martin, Sarah Fadich.

Data Analysis: Emily Clennon, Geolani Dy.

Manuscript Preparation: Emily Clennon, Craig Sineath, Gaines Blasdel, Geolani Dy.

Manuscript Review and Editing: Emily Clennon, Geolani Dy, Gaines Blasdel, Craig Sineath, Leigh Martin, Sarah Fadich.

Funding Acquisition and Project Supervision: Geolani Dy.

Corresponding author

Correspondence to Emily K. Clennon.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Ethics Approval

Not applicable.

Consent to Participate

Not applicable.

Consent for Publication

Not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Male and Female Surgical Interventions

Appendix 1

Appendix 1

Final query strings by database.

PubMed Query

((transgender OR dysphoria OR transsexual) AND surgery AND (affirm* OR gender-affirm* OR gender confirm* OR gender-confirm* OR reassign* OR transsexual) AND ("patient reported outcome" OR "patient-reported outcome" OR satisfaction OR quality of life OR quality-of-life)) OR ((((((((((((((("Transgender Persons"[Mesh]) OR "Transsexualism"[Mesh]) OR "Gender Identity"[Mesh]) OR "Sexual and Gender Minorities"[Mesh]) OR "Gender Dysphoria"[Mesh]) OR (transgender[Title/Abstract])) OR (transsexual[Title/Abstract])) OR (gender identity[Title/Abstract])) OR (sexual minority[Title/Abstract])) OR (gender minority[Title/Abstract])) OR (sexual minorities[Title/Abstract])) OR (gender minorities[Title/Abstract])) OR (gender dysphoria[Title/Abstract])) AND (((((((("Sex Reassignment Surgery"[Mesh]) OR "Sex Reassignment Procedures"[Mesh]) OR "Health Services for Transgender Persons"[Mesh]) OR "Surgical Procedures, Operative"[Mesh]) OR (sex reassignment[Title/Abstract])) OR (surgery[Title/Abstract])) OR (surgical[Title/Abstract])) OR (health services[Title/Abstract]))) AND (((((("Patient Reported Outcome Measures"[Mesh]) OR "Patient Outcome Assessment"[Mesh]) OR (patient reported outcomes[Title/Abstract])) OR (patient outcome assessment[Title/Abstract])) OR (patient outcomes assessment[Title/Abstract])) OR (((quality of life[Title/Abstract]) OR (patient satisfaction[Title/Abstract])) OR (("Quality of Life"[Mesh]) OR "Patient Satisfaction"[Mesh])))).

Scopus Query

( TITLE-ABS-KEY ( transgender OR dysphoria OR transsexual OR "transgender persons" OR transsexualism OR "gender identity" OR "sexual and gender minorities" OR "gender dysphoria") AND TITLE-ABS-KEY ( ( surgery AND ( affirm* OR gender-affirm* OR gender AND confirm* OR gender-confirm* OR reassign* OR transsexual)) OR "sex reassignment") AND TITLE-ABS-KEY ( ( "patient reported outcome" OR "patient-reported outcome" OR "patient satisfaction" OR quality AND of AND life OR quality-of-life))).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Clennon, E.K., Martin, L.H., Fadich, S.K. et al. Community Engagement and Patient-Centered Implementation of Patient-Reported Outcome Measures (PROMs) in Gender Affirming Surgery: a Systematic Review. Curr Sex Health Rep 14, 17–29 (2022). https://doi.org/10.1007/s11930-021-00323-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11930-021-00323-6

Keywords

Search

Navigation