Danish translation and linguistic validation of the GENDER-Q, a patient-reported outcome measure for use in gender-affirming care

BackgroundGlobally, the number of individuals identifying as transgender and gender-diverse [TGD] has grown in the last decade. This study aimed to perform a Danish linguistic translation and cultural adaptation of the GENDER-Q, a new patient-reported outcome measure [PROM] designed to evaluate outcomes of gender-affirming care.MethodsThe field test version of the GENDER-Q (959 items) was translated into Danish using guidelines from the International Society of Pharmacoeconomics and Outcomes Research and the World Health Organization to ensure accuracy, cultural relevance, and validity. This included two forward translations, a backward translation, an expert panel meeting, and two rounds of patient cognitive interviews.ResultsThe forward translations resulted in revisions of 142 items, which were then harmonized to form the backward translation version. A comparison of the back translation to the original questionnaire led to a total of 43 changes to items and response options. The revised version was reviewed in an expert panel meeting and minor changes were made with 28 patient participants using cognitive debriefing interviews. The translated version was proofread, resulting in the Danish translation of the GENDER-Q.ConclusionsThe GENDER-Q was translated and culturally adapted for use in the Danish TGD adult population. The GENDER-Q has the potential to enhance the understanding and improvement of treatment and health-related quality-of-life outcomes for adults seeking gender-affirming care.Level of Evidence:Not gradable.