The Plastic Surgery Foundation
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Grants We Funded

In 2019, The Plastic Surgery Foundation (The PSF) awarded 33 investigator-initiated projects and allocated $891,274 to support the newest, clinically relevant research in plastic surgery.

The American Society of Plastic Surgeons/PSF leadership is committed to continuing to provide high levels of investigator-initiated research support to ensure that plastic surgeons have the needed research resources to be pioneers and innovators in advancing the practice of medicine.

Research Abstracts

Search The PSF database to have easy access to full-text grant abstracts from past PSF-funded research projects 2003 to present. All abstracts are the work of the Principal Investigators and were retrieved from their PSF grant applications. Several different filters may be applied to locate abstracts specific to a particular focus area, or PSF funding mechanism.

Developing the TRANS-Q to Measure Outcomes for Gender-Affirming Treatment

Principal Investigator
Anne Klassen PhD


McMaster University, Faculty of Health Sciences

Funding Mechanism
National Endowment for Plastic Surgery Grant

Focus Area
Economics/Quality/Outcomes, General Reconstructive

There are 25 million transgender people in the world (1-2 per 100 people) and no patient-reported outcome instrument developed to measure the health concepts that matter the most to them. Transgender is a term used to describe people who experience incongruence (i.e., gender dysphoria) between their gender identity and the sex assigned to them at birth. Treatments include hormonal therapy and sex-reassignment surgeries performed by plastic surgeons. Since gender confirming treatments often require complex and individualized interventions, highly specific PRO scales are required. Our team recently developed 2scales to measure appearance of the chest and nipples as a supplement to the BODY-Q. The scales were field-tested in an international (Canada, USA, Denmark, Netherlands) heterogeneous sample that included 341 gender confirming chest surgery patients. These scales represents the first step in our team's program of research to develop a comprehensive transgender-specific PRO instrument. PRO scales are urgently needed to cover the full range transgender-specific treatments that aim to alter facial, breast/chest and genital appearance and function. To develop such scales, we will adapt existing BREAST-Q and FACE-Q scales that our team previously designed that we hypothesize have content validity for the transgender population. We will also develop new scales as needed (e.g., to evaluate outcomes following genital reconstruction). The chest and nipples scales, plus the adapted and new scales, will be collectively included in a PRO instrument called TRANS-Q. The specific AIM of the proposed one-year study is to conduct a Phase 1 qualitative study to develop a set of independently functioning PRO scales that can be used in research and clinical practice to evaluate gender confirming treatments. The qualitative sample will include 50 adolescent and adults aged 16 and older recruited from sites in Canada and the USA. Interviews will be audio-recorded, transcribed and analysed. Patient interviews and expert input will be used to review and refine scales and develop new ones as needed. At the end of this Phase, the TRANS-Q will be ready to field-test.

Klassen completed a doctorate in Health Services Research at the University of Oxford in 1997. She subsequently received a Killam postdoctoral fellowship, followed by consecutive awards from the Canadian Institute of Health Research (CIHR), i.e., postdoctoral fellowship, new investigator and mid-career. She is currently Professor of Pediatrics and Associate Member of the Department of Health Research Methodology, Evidence and Impact and Scientist in the CanChild Center for Childhood Disability Research. She is internationally known as an applied health services researcher with expertise in developing patient-reported outcome (PRO) instruments. She uses state-of-the-art methods based on Rasch Measurement Theory to maximize the clinical meaning and scientific quality of the PRO instruments produced. To address the lack of available PRO instruments for use in pediatric and adult plastic and reconstructive surgery, she co-developed the following instruments: BREAST-Q, FACE-Q, BODY-Q, SCAR-Q, WOUND-Q, CLEFT-Q and FACE-Q Kids. These measures are being used by governments, organizations, industry, academia, and clinicians, helping to transform healthcare delivery and patient outcomes.