Iris de Nie

23 REFLECTING ON THE IMPORTANCE OF FAMILY BUILDING AND FERTILITY PRESERVATION 2 treatment, if they were above the age of 21 years at initiation of medical treatment, or if they were diagnosed with a disorder of sex development. Study design and data collection Participants were asked to complete an online survey about how they experienced their medical treatment, and on psychological functioning, experienced gender dysphoria, sexuality and fertility. For the current study, only demographic data and the results of fertility questionnaires were used. The other data will be published in upcoming papers. The fertility questionnaire was developed by a multidisciplinary team and focused on different themes, such as fertility counseling at initiation of medical treatment, decision-making about fertility preservation, current feelings about infertility, and a potential desire to have children. All participants initiated medical treatment before 2014, when strict transgender laws were still in place which required a sterilization for legal gender recognition in the Netherlands. Therefore, the questionnaire was divided in a ‘past’ and ‘present’ section, to make a clear distinction between how participants experienced their decision-making process regarding fertility at initiation of treatment within the possibilities that were available at that time, and how they reflect on these decisions and possibilities with today’s knowledge. The questionnaire consisted of approximately 25 multiple choice questions of which the majority contained the option to add an open text format answer in case none of the pre-defined responses were applicable. In addition, some open-ended questions gave the respondent the option to formulate their own answers and expand on them. After completion of the survey, a telephonic interview was conducted for further clarification of ambiguous answers and to give participants the possibility to elaborate on topics that were not specifically mentioned in the survey. The telephonic interview was written down in a summarized form. Statistical analysis For each participant, information obtained from the telephonic interview was used to validate the provided answers in the survey and, if applicable, data were supplemented or corrected. Subsequently, data from the surveys were analyzed using STATA Statistical Software, version 15.1 (Statacorp, College Station, TX, USA) and presented as numbers with percentages. Baseline characteristics of the study population are expressed as mean with standard deviation (SD) when normally distributed, and as median with interquartile range (IQR) when non-normally distributed. With use of ATLAS.ti version 9 (ALTAS.ti Scientific Software Development GmbH for Windows, Germany), information from the open-ended questions was coded and interpreted by two of the researchers. The codes that emerged were further thematically organized in larger categories. In the presentation of the data, the emerged themes will be presented supported by illustrative quotes. To check for accuracy, quotes were translated and retranslated. The study protocol was assessed by the Ethics Review Board of the VU University Medical Centre Amsterdam and it was concluded that the Medical Research Involving Human Subjects Act (WMO) did not apply to this study.