P4.066: Development of Quality Measures for Transgender Clinics in Thailand: A Delphi Method Approach

Purpose/Objectives: To develop a consensus-based set of quality measures for transgender clinics in Thailand, addressing critical healthcare areas such as hormone therapy follow-up, monitoring for hormone-related side effects, infection screening, and cancer screening tailored to transitioned anatomy.

Design/Methods: A three-round Delphi study was conducted from January to June 2024. Twenty experts (endocrinologists, psychiatrists, surgeons, nursing staff, mental health professionals, and transgender community representatives) were purposively selected. In Round 1, open-ended questionnaires captured potential quality indicators. In Rounds 2 and 3, participants rated each indicator on clarity, feasibility, and relevance using a 5-point Likert scale; items were retained if ≥80% of participants rated them as “important” (≥4).

Results: From an initial pool of 42 indicators, 28 reached consensus after two rating rounds. These indicators were grouped into five domains: (1) clinical effectiveness (e.g., structured hormone follow-up, monitoring hormone side effects, recommended infection screening, and cancer screening protocols), (2) patient-centeredness, (3) accessibility, (4) coordination and continuity of care, and (5) cultural competency. The mean rating for the final indicators was 4.5 (SD 0.3), reflecting an 84% agreement rate.

Conclusion/Discussion: This Delphi study established a comprehensive framework of 28 quality measures specifically designed for transgender clinics in Thailand. Incorporating targeted hormone management, infection risk assessments, and cancer surveillance, these measures have the potential to improve clinical outcomes, patient satisfaction, and healthcare service delivery. Future research should focus on validating these measures in clinical settings and advocating for their integration into national healthcare quality policies.