Pre-Surgical Mental Health Readiness Assessments for Gender Affirming Surgeries: A Survey of Canadian Practices
Bibliographic record
Abstract
Practitioners providing pre-surgical assessments for gender affirming surgery in Canada (N=70) were surveyed on their assessment procedures, their interpretations of the World Professional Association for Transgender Health Standards of Care (SOC7) guidelines, and perspectives on future referral strategies. Most practitioners identified the SOC7 as their main or only source of pre-surgical assessment guidelines, although many other guidelines were cited as key resources. A significant proportion of practitioners indicated they used personally developed guidelines. Practitioners demonstrated a preference for decision making models other than the SOC7, the most popular being a direct referral from a primary care provider with the option of a mental health consult in the case of complex mental health presentations. Most practitioners approved of the trend towards an informed consent model for accessing gender affirming surgery, though the importance of mental health experts™ involvement was recognized. This cross-sectional survey demonstrates the importance of updated WPATH standards of care, and the development and adherence to a standardized evidence-based approach to pre-surgical mental health assessment for gender affirming surgery across Canada.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".