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Readability of Online Resources for Gender Reassignment Surgery
Christina R. Vargas, MD; Michelle Lee, MD; Daniel Medalie, MD; Bernard T. Lee, MD, MBA, MPH
University Hospitals Case Medical Center / Case Western Reserve University
2016-01-14
Presenter: Christina R. Vargas, MD
Affidavit:
Dr Soltanian is the program director of Case Western Plastic Surgery and approves this submission. The entirety of the data collection, analysis, and abstract composition represent the original work of the resident.
Director Name: Hooman Soltanian, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background: Patient use of internet resources for health information is increasing. As the incidence of gender reassignment surgery rises, patient access to appropriate educational material is critical. The American Medical Association and National Institutes of Health have recommended that information for patients should be written at a sixth grade reading level. This study aims to simulate a patient search for online educational material about gender reassignment surgery and to evaluate it in the context of these recommendations.
Methods: Internet searches for the terms, "transgender surgery" and "sex reassignment surgery" were performed, and the first ten relevant hits were identified. Sponsored results were excluded. Patient information from each site was downloaded and formatted into plain text. Readability was assessed using nine established tests.
Results: 97 articles were collected; overall mean reading grade level was 14.8 (college sophomore level). Overall scores by test were: Coleman-Liau 14.2, Flesch-Kincaid 15.4, FORCAST 11.7, Fry 16, Gunning Fog 16.5, New Dale-Chall 14.6, New Fog Count 13.5, Raygor Estimate 15, and SMOG 16.5. All articles exceeded the recommended 6th grade level.
Conclusions: Online patient information about gender reassignment surgery is too difficult for a significant portion of American adults to read. As such, it may contribute to disparities in patient access, understanding, involvement, satisfaction, and outcomes. Reliable, accessible, and readable information is needed for patients considering gender reassignment surgery; surgeons should be aware that patients with lower literacy skills may require additional counseling.
