An Iterative Model of Informed Consent: A Trauma-Informed Approach to Consent in Gender-Affirming Surgery

An Iterative Model of Informed Consent: A Trauma-Informed Approach to Consent in Gender-Affirming Surgery
Elijah R. Castle, Rey L. Daigle, Andres Cazares, Nathan Levitt, Augustus Klein
Transgender Health, 31 March 2025
Abstract
Discourse regarding informed consent in trans health care generally addresses overarching interventions (hormones, surgery) and not specific details of these interventions (who will be involved, what kind of and where touch is required), which threatens patient autonomy and bodily agency and reinforces power imbalances inherent in health care. Pelvic care has made the case for a trauma-informed approach to informed consent, which offers a strategy to discuss these specific details and mitigate such threats. In this article, we provide guidance for how clinicians working in gender-affirming surgery can implement a trauma-informed approach to informed consent through an iterative model of informed consent.

Editor’s Note: The article states that “Principles of trauma-informed care stipulate that the clinician should seek consent for each part of the exam and, importantly, that the patient can stop the exam at any time.”