Co-design sessions: representative illustrative quotations about AFFRMED by parents and youth/young adults.
| Content area . | Quote(s) . |
|---|---|
| Presentation of content | “This is great. Maybe this could be something I go through with my kid. Or could go through it separately but then talk about it.” (Parent of 11-year-old trans girl) |
| “One thing I appreciate is that it helps me talk to my kid about anatomy without using gender. This does a great job of doing that. This isn’t natural language to me so it’s helpful to have this as a guide.” (Parent of 10-year-old child) | |
| “Growing up, we didn’t even cover the basics of puberty in school. So this is good for people who didn’t get that information. It is a difficult topic that is hard to depict. But if you’re deciding to look at this decision aid, you know what you’re getting into.” (23-year-old trans man) | |
| Visual aesthetics | “I like that colors and associated body parts are consistent. It helps explain what you are looking at.” (Parent of 16-year-old boy) |
| “I like the pictures. I see some ovaries, a uterus and some testicles.” (10-year-old trans boy) | |
| “Someone’s taking testosterone and growing a beard. His voice got deeper, and his ovaries are decreasing.” (10-year-old trans boy) | |
| Ease of use | “When you have pictures that are more realistic, there’s a tendency to glaze over that. This is like, I’m friendly, happy. I like that for a kid who’s 7 or 8 or exploring about this, they’re getting hit with sex education which is so dry so this is more conducive to any kid. Even as adult I’m attracted to more animated images.” (Parent of 14-year-old nonbinary person) |
| “I really like it. Having a way to have info presented nicely, not just scouring the internet and it’s right here and interactive and audiovisual, will make a big a difference.” (21-year-old trans woman) | |
| Overall impression | “Overall it wasn’t pushing you to do fertility preservation. It was neutral and unbiased. It presented the two options and what could come out of each option.” (Parent of 13-year-old trans boy) |
| “I like that you show the different options for having children other than biologically having them and show the pros and cons of adopting and fostering. You also clarified that this decision is difficult and that it is ok whatever decision you make and okay to change your mind.” (16-year-old boy) | |
| “I can see this being offered to me during my first few clinic appointments.” (16-year-old boy) | |
| Tone of decision aid | “The tone was gender-friendly, serious but approachable and friendly.” (Parent of 16-year-old boy) |
| “I really like the tone. You have done an amazing job of getting a lot of info into simple, user-friendly language. This isn’t easy content to bring to that level concreteness. Great work.” (Parent of 10-year-old child) | |
| “The tone is informative and friendly, a tone of allyship.” (21-year-old trans woman) | |
| “The tone was definitely not biased. If you do not want to have children or pursue fertility preservation, that’s ok.” (14-year-old nonbinary person) | |
| Areas for improvement | “I’d want to know other side effects [of ovarian stimulation hormone shots], and how long that would last. It’s not just 2 weeks and you go back to whatever. When could they resume cross hormones?” (Parent of 12-year-old boy) |
| “This is definitely lost on a 7- or 8-year-old. It’s a lot of stuff. Great for a parent who wants to know all the steps but for a kid it’s overwhelming. The language is still trying to be simplistic but this is all…a kid would be overwhelmed.” (Parent of 14-year-old nonbinary person) | |
| “I have questions about if the amount of time on gender-affirming hormones might affect the procedure [for fertility preservation]. Like if taking for a few years, would it be possible to preserve?” (20-year-old nonbinary person) | |
| “I would have questions about stopping hormones [to pursue fertility preservation] … The idea of losing progress and hormone levels returning to levels when starting hormones… How long would someone have to stop if they were preserving fertility?” (20-year-old genderqueer person) |
| Content area . | Quote(s) . |
|---|---|
| Presentation of content | “This is great. Maybe this could be something I go through with my kid. Or could go through it separately but then talk about it.” (Parent of 11-year-old trans girl) |
| “One thing I appreciate is that it helps me talk to my kid about anatomy without using gender. This does a great job of doing that. This isn’t natural language to me so it’s helpful to have this as a guide.” (Parent of 10-year-old child) | |
| “Growing up, we didn’t even cover the basics of puberty in school. So this is good for people who didn’t get that information. It is a difficult topic that is hard to depict. But if you’re deciding to look at this decision aid, you know what you’re getting into.” (23-year-old trans man) | |
| Visual aesthetics | “I like that colors and associated body parts are consistent. It helps explain what you are looking at.” (Parent of 16-year-old boy) |
| “I like the pictures. I see some ovaries, a uterus and some testicles.” (10-year-old trans boy) | |
| “Someone’s taking testosterone and growing a beard. His voice got deeper, and his ovaries are decreasing.” (10-year-old trans boy) | |
| Ease of use | “When you have pictures that are more realistic, there’s a tendency to glaze over that. This is like, I’m friendly, happy. I like that for a kid who’s 7 or 8 or exploring about this, they’re getting hit with sex education which is so dry so this is more conducive to any kid. Even as adult I’m attracted to more animated images.” (Parent of 14-year-old nonbinary person) |
| “I really like it. Having a way to have info presented nicely, not just scouring the internet and it’s right here and interactive and audiovisual, will make a big a difference.” (21-year-old trans woman) | |
| Overall impression | “Overall it wasn’t pushing you to do fertility preservation. It was neutral and unbiased. It presented the two options and what could come out of each option.” (Parent of 13-year-old trans boy) |
| “I like that you show the different options for having children other than biologically having them and show the pros and cons of adopting and fostering. You also clarified that this decision is difficult and that it is ok whatever decision you make and okay to change your mind.” (16-year-old boy) | |
| “I can see this being offered to me during my first few clinic appointments.” (16-year-old boy) | |
| Tone of decision aid | “The tone was gender-friendly, serious but approachable and friendly.” (Parent of 16-year-old boy) |
| “I really like the tone. You have done an amazing job of getting a lot of info into simple, user-friendly language. This isn’t easy content to bring to that level concreteness. Great work.” (Parent of 10-year-old child) | |
| “The tone is informative and friendly, a tone of allyship.” (21-year-old trans woman) | |
| “The tone was definitely not biased. If you do not want to have children or pursue fertility preservation, that’s ok.” (14-year-old nonbinary person) | |
| Areas for improvement | “I’d want to know other side effects [of ovarian stimulation hormone shots], and how long that would last. It’s not just 2 weeks and you go back to whatever. When could they resume cross hormones?” (Parent of 12-year-old boy) |
| “This is definitely lost on a 7- or 8-year-old. It’s a lot of stuff. Great for a parent who wants to know all the steps but for a kid it’s overwhelming. The language is still trying to be simplistic but this is all…a kid would be overwhelmed.” (Parent of 14-year-old nonbinary person) | |
| “I have questions about if the amount of time on gender-affirming hormones might affect the procedure [for fertility preservation]. Like if taking for a few years, would it be possible to preserve?” (20-year-old nonbinary person) | |
| “I would have questions about stopping hormones [to pursue fertility preservation] … The idea of losing progress and hormone levels returning to levels when starting hormones… How long would someone have to stop if they were preserving fertility?” (20-year-old genderqueer person) |
Note. For gender descriptors, we used terms self-reported by participants.
Co-design sessions: representative illustrative quotations about AFFRMED by parents and youth/young adults.
| Content area . | Quote(s) . |
|---|---|
| Presentation of content | “This is great. Maybe this could be something I go through with my kid. Or could go through it separately but then talk about it.” (Parent of 11-year-old trans girl) |
| “One thing I appreciate is that it helps me talk to my kid about anatomy without using gender. This does a great job of doing that. This isn’t natural language to me so it’s helpful to have this as a guide.” (Parent of 10-year-old child) | |
| “Growing up, we didn’t even cover the basics of puberty in school. So this is good for people who didn’t get that information. It is a difficult topic that is hard to depict. But if you’re deciding to look at this decision aid, you know what you’re getting into.” (23-year-old trans man) | |
| Visual aesthetics | “I like that colors and associated body parts are consistent. It helps explain what you are looking at.” (Parent of 16-year-old boy) |
| “I like the pictures. I see some ovaries, a uterus and some testicles.” (10-year-old trans boy) | |
| “Someone’s taking testosterone and growing a beard. His voice got deeper, and his ovaries are decreasing.” (10-year-old trans boy) | |
| Ease of use | “When you have pictures that are more realistic, there’s a tendency to glaze over that. This is like, I’m friendly, happy. I like that for a kid who’s 7 or 8 or exploring about this, they’re getting hit with sex education which is so dry so this is more conducive to any kid. Even as adult I’m attracted to more animated images.” (Parent of 14-year-old nonbinary person) |
| “I really like it. Having a way to have info presented nicely, not just scouring the internet and it’s right here and interactive and audiovisual, will make a big a difference.” (21-year-old trans woman) | |
| Overall impression | “Overall it wasn’t pushing you to do fertility preservation. It was neutral and unbiased. It presented the two options and what could come out of each option.” (Parent of 13-year-old trans boy) |
| “I like that you show the different options for having children other than biologically having them and show the pros and cons of adopting and fostering. You also clarified that this decision is difficult and that it is ok whatever decision you make and okay to change your mind.” (16-year-old boy) | |
| “I can see this being offered to me during my first few clinic appointments.” (16-year-old boy) | |
| Tone of decision aid | “The tone was gender-friendly, serious but approachable and friendly.” (Parent of 16-year-old boy) |
| “I really like the tone. You have done an amazing job of getting a lot of info into simple, user-friendly language. This isn’t easy content to bring to that level concreteness. Great work.” (Parent of 10-year-old child) | |
| “The tone is informative and friendly, a tone of allyship.” (21-year-old trans woman) | |
| “The tone was definitely not biased. If you do not want to have children or pursue fertility preservation, that’s ok.” (14-year-old nonbinary person) | |
| Areas for improvement | “I’d want to know other side effects [of ovarian stimulation hormone shots], and how long that would last. It’s not just 2 weeks and you go back to whatever. When could they resume cross hormones?” (Parent of 12-year-old boy) |
| “This is definitely lost on a 7- or 8-year-old. It’s a lot of stuff. Great for a parent who wants to know all the steps but for a kid it’s overwhelming. The language is still trying to be simplistic but this is all…a kid would be overwhelmed.” (Parent of 14-year-old nonbinary person) | |
| “I have questions about if the amount of time on gender-affirming hormones might affect the procedure [for fertility preservation]. Like if taking for a few years, would it be possible to preserve?” (20-year-old nonbinary person) | |
| “I would have questions about stopping hormones [to pursue fertility preservation] … The idea of losing progress and hormone levels returning to levels when starting hormones… How long would someone have to stop if they were preserving fertility?” (20-year-old genderqueer person) |
| Content area . | Quote(s) . |
|---|---|
| Presentation of content | “This is great. Maybe this could be something I go through with my kid. Or could go through it separately but then talk about it.” (Parent of 11-year-old trans girl) |
| “One thing I appreciate is that it helps me talk to my kid about anatomy without using gender. This does a great job of doing that. This isn’t natural language to me so it’s helpful to have this as a guide.” (Parent of 10-year-old child) | |
| “Growing up, we didn’t even cover the basics of puberty in school. So this is good for people who didn’t get that information. It is a difficult topic that is hard to depict. But if you’re deciding to look at this decision aid, you know what you’re getting into.” (23-year-old trans man) | |
| Visual aesthetics | “I like that colors and associated body parts are consistent. It helps explain what you are looking at.” (Parent of 16-year-old boy) |
| “I like the pictures. I see some ovaries, a uterus and some testicles.” (10-year-old trans boy) | |
| “Someone’s taking testosterone and growing a beard. His voice got deeper, and his ovaries are decreasing.” (10-year-old trans boy) | |
| Ease of use | “When you have pictures that are more realistic, there’s a tendency to glaze over that. This is like, I’m friendly, happy. I like that for a kid who’s 7 or 8 or exploring about this, they’re getting hit with sex education which is so dry so this is more conducive to any kid. Even as adult I’m attracted to more animated images.” (Parent of 14-year-old nonbinary person) |
| “I really like it. Having a way to have info presented nicely, not just scouring the internet and it’s right here and interactive and audiovisual, will make a big a difference.” (21-year-old trans woman) | |
| Overall impression | “Overall it wasn’t pushing you to do fertility preservation. It was neutral and unbiased. It presented the two options and what could come out of each option.” (Parent of 13-year-old trans boy) |
| “I like that you show the different options for having children other than biologically having them and show the pros and cons of adopting and fostering. You also clarified that this decision is difficult and that it is ok whatever decision you make and okay to change your mind.” (16-year-old boy) | |
| “I can see this being offered to me during my first few clinic appointments.” (16-year-old boy) | |
| Tone of decision aid | “The tone was gender-friendly, serious but approachable and friendly.” (Parent of 16-year-old boy) |
| “I really like the tone. You have done an amazing job of getting a lot of info into simple, user-friendly language. This isn’t easy content to bring to that level concreteness. Great work.” (Parent of 10-year-old child) | |
| “The tone is informative and friendly, a tone of allyship.” (21-year-old trans woman) | |
| “The tone was definitely not biased. If you do not want to have children or pursue fertility preservation, that’s ok.” (14-year-old nonbinary person) | |
| Areas for improvement | “I’d want to know other side effects [of ovarian stimulation hormone shots], and how long that would last. It’s not just 2 weeks and you go back to whatever. When could they resume cross hormones?” (Parent of 12-year-old boy) |
| “This is definitely lost on a 7- or 8-year-old. It’s a lot of stuff. Great for a parent who wants to know all the steps but for a kid it’s overwhelming. The language is still trying to be simplistic but this is all…a kid would be overwhelmed.” (Parent of 14-year-old nonbinary person) | |
| “I have questions about if the amount of time on gender-affirming hormones might affect the procedure [for fertility preservation]. Like if taking for a few years, would it be possible to preserve?” (20-year-old nonbinary person) | |
| “I would have questions about stopping hormones [to pursue fertility preservation] … The idea of losing progress and hormone levels returning to levels when starting hormones… How long would someone have to stop if they were preserving fertility?” (20-year-old genderqueer person) |
Note. For gender descriptors, we used terms self-reported by participants.
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