Gender expression is associated with selection of uterine preservation or hysterectomy for pelvic organ prolapse surgery: Novel methodology for sex‐ and gender‐based analysis in gynecologic research

Shannon Cummings, Kaylee Ramage, Natalie V. Scime, Sofia B. Ahmed, Erin A. Brennand
In: International Journal of Gynecology & Obstetrics · 2022 · vol. 159(2) , pp. 522–529 · doi:10.1002/ijgo.14169 · PMID:35262193 · W4220877393
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Abstract

OBJECTIVE: To explore whether patient characteristics were associated with gender expression, and to further determine impact of gender expression on patient selection of hysterectomy or uterine-preservation in pelvic organ prolapse (POP) surgery. METHODS: Within a prospective cohort, a self-reported gender expression tool classified patients as expressing gender polar (i.e., reporting only feminine traits) or non-polar gender scores (i.e., reporting feminine and masculine traits). Multivariate modeling explored associations of gender expression with traditional socio-demographic variables, and with selection of hysterectomy or uterine-preserving surgery. Descriptive statistics of socio-demographic variables were reported by frequency, proportion and mean (SD). RESULTS: 177 participants completed the gender score questionnaire. Overall, the sample had a more feminine gender expression with the majority of respondents classified as gender polar (67.23%, n = 119). Participants with non-polar gender scores were 2.53 times (95% 1.05-6.09) more likely to choose uterine preservation versus hysterectomy-based surgery. Gender polarity was weakly associated with age, but no other sociodemographic variables. CONCLUSION: Gender expression is not tightly associated with socio-demographic variables, and is thus a novel measurement in gynecologic research. Gender polarity appears to be associated with choice to undergo hysterectomy. Further research is required to understand this relationship and implications in clinical outcomes.

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