{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:03:40Z","timestamp":1789736620740,"version":"4.0.1"},"reference-count":38,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":242,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institute of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gender-affirming facial interventions aim to align facial features of people who identify as transgender or gender diverse (TGD) with their gender identity. GENDER-Q is a comprehensive patient-reported outcome measure with 11 scales that measure satisfaction with the face overall, facial features, specific facial areas, and laryngeal prominence (Adam's apple).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of the study was to examine construct validity for the face and neck scales in an international sample of people who identify as TGD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An international cross-sectional survey collected GENDER-Q data between February 2022 and March 2024. Participants were aged 18\u2005years and older and had sought or received gender-affirming care within the past 5\u2005years. Predefined hypotheses for expected group-level differences and correlations between GENDER-Q scales were tested using independent t-tests, analysis of variance, and Pearson correlation coefficients. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline was followed to establish construct validity (ie, \u226575% hypotheses confirmed).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 4890 participants completed the GENDER-Q Face Overall scale and additional scales as relevant. The sample identified as man (33%), woman (37%), nonbinary (24%), and other gender (6%). The percentage of hypotheses that met the COSMIN criteria of evidence of construct validity ranged from 78% to 100% for the 11 scales. As hypothesized, participants who had undergone gender-affirming facial procedures reported significantly higher satisfaction with appearance scores than those who wanted surgery or required revision surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>GENDER-Q scales met COSMIN criteria for hypothesis-based construct validity. GENDER-Q can be used to inform clinical care and to advance research regarding gender-affirming facial interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 3 (Therapeutic)<\/jats:title>\n                    <jats:p\/>\n                  <\/jats:sec>","DOI":"10.1093\/asjof\/ojag157","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:42:58Z","timestamp":1787312578000},"source":"Crossref","is-referenced-by-count":0,"title":["Construct Validity of the GENDER-Q Face and Neck Scales in 4890 Transgender and Gender Diverse Adults"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4720-0096","authenticated-orcid":false,"given":"Anne F","family":"Klassen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manraj 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