Development of an Online Contraceptive Decision Aid for Transgender and Gender-Nonconforming Assigned Female at Birth Individuals

Transgender and gender-nonconforming assigned female at birth (AFAB) individuals are consistently excluded when discussing sexual health and contraceptive methods and face unique challenges in accessing sexual healthcare as gender dysphoria heavily influences their decision-making process as well as fear of discrimination from healthcare providers and settings. The research aim of this project is to develop an online contraceptive decision aid tailored to transgender and gender-nonconforming AFAB individuals. MyChoiceForAll is built using the gaps identified in healthcare research and existing resources provided by Planned Parenthood and Bedsider, alongside feedback from a development focus group. The tool is a four-paged quiz that returns two pages of information and resources for a variety of different contraceptive methods for transgender and gender-nonconforming AFAB individuals as well as connecting them to trans-friendly providers. The evaluation phase includes simulated test cases, a survey, and a second focus group to assess for accuracy, usefulness, usability, and general impressions of the tool. 94.3% of the 105 test cases resulted in an accurate recommendation that aligns with user input. Over 75.00% of survey participants overwhelmingly believed the MyChoiceForAll tool to be beneficial in providing appropriate and inclusive educational material about contraceptives, prompting users for relevant lifestyle, preferences, and gender identity decision factors, and being overall inclusive of users’ gender identity. Evaluation focus group participants believe that MyChoiceForAll performs better overall compared to the Planned Parenthood quiz, Bedsider matrix, and MyContraceptiveChoice in general impressions and inclusivity of transgender and gender-nonconforming individuals and their preferences. In conclusion, MyChoiceForAll accomplishes its goal of developing an accessible and inclusive resource for transgender and gender-nonconforming AFAB individuals in assisting with the birth control selection process.