Impact of Gender Identity on Dentists' Clinical Decision-Making (GID-CDM)

Does Gender Identity Influence Dentists' Clinical Decision-Making? A Randomized Study

This randomized study evaluated whether patient gender identity influences dentists' clinical decision-making. Dentists in southern Brazil were randomly assigned to receive one of two versions of the same hypothetical dental clinical case. The cases were identical except for the patient's gender identity, which was presented as either a transgender woman or a cisgender woman.

Participants selected treatment options for anterior and posterior teeth and completed questionnaires regarding professional characteristics and knowledge about transgender health. The primary objective was to determine whether patient gender identity influenced treatment recommendations. Differences in clinical decision-making between groups were analyzed using regression models.

Study Overview

• Status: Completed
• Conditions: Transgender Persons; Gender Identity; Clinical Decision-Making
• Intervention / Treatment: Behavioral: Clinical Case Scenario

Detailed Description

Clinical decision-making in dentistry may be influenced by factors beyond clinical findings, including professional characteristics, personal beliefs, and social perceptions. While disparities related to race and socioeconomic status have been documented in oral health care, little is known about the influence of patient gender identity on dentists' treatment decisions.

This randomized parallel-group study was conducted among practicing dentists in southern Brazil between September 2023 and April 2024. Participants were randomly assigned to evaluate one of two versions of a hypothetical dental clinical case. The clinical information, photographs, complaints, and treatment scenarios were identical in both versions, differing only in the patient's gender identity. In one version, the patient was identified as a transgender woman, while in the other the patient was identified as a cisgender woman.

Participants selected treatment options for an anterior tooth and a posterior tooth and subsequently completed questionnaires addressing sociodemographic characteristics, professional profile, previous experience with transgender patients, and training related to transgender health. The primary outcome was the treatment recommendation provided by the dentist. Recommendations were categorized into conservative and invasive treatment approaches for analysis.

The study aimed to determine whether patient gender identity influences dentists' clinical decision-making and to identify professional characteristics associated with treatment recommendations.

• Study Type: Interventional
• Enrollment (Actual): 204
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Brazil
  • Rio Grande do Sul
    • Santa Maria, Rio Grande do Sul, Brazil, 97501-650
      • Universidade Federal de Santa Maria

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Professionally active dentists.
• Able and willing to provide informed consent.
• Practicing dentistry during the data collection period.

Exclusion Criteria:

• Dentists not actively practicing during the data collection period.
• Dentists who participated in the pilot study.
• Individuals who declined participation or did not provide informed consent.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Transgender Woman Case; Participants evaluated a hypothetical dental clinical case in which the patient was identified as a transgender woman. Clinical information, complaints, and treatment options were identical to the comparison arm.	Behavioral: Clinical Case Scenario; Participants were randomly assigned to evaluate one of two versions of a hypothetical dental clinical case. The cases contained identical clinical information, photographs, complaints, and treatment options, differing only in the patient's gender identity. One version described a transgender woman and the other described a cisgender woman. Participants selected treatment recommendations based on the assigned scenario.
Experimental: Cisgender Woman Case; Participants evaluated a hypothetical dental clinical case in which the patient was identified as a cisgender woman. Clinical information, complaints, and treatment options were identical to the comparison arm.	Behavioral: Clinical Case Scenario; Participants were randomly assigned to evaluate one of two versions of a hypothetical dental clinical case. The cases contained identical clinical information, photographs, complaints, and treatment options, differing only in the patient's gender identity. One version described a transgender woman and the other described a cisgender woman. Participants selected treatment recommendations based on the assigned scenario.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Treatment Recommendation for Posterior Tooth	Treatment recommendation for tooth 26 based on the assigned clinical case. Available options included endodontic treatment followed by direct composite restoration, endodontic treatment followed by indirect ceramic restoration, or extraction.	Immediately after questionnaire completion
Treatment Recommendation for Anterior Tooth	Treatment recommendation for tooth 11 based on the assigned clinical case. Available options included no intervention, repair of the composite restoration, replacement of the restoration, direct composite veneer, or indirect ceramic veneer.	Immediately after questionnaire completion

Collaborators and Investigators

• Sponsor: Universidade Federal de Santa Maria

Study record dates

Study Major Dates

• Study Start (Actual): September 12, 2023
• Primary Completion (Actual): April 9, 2024
• Study Completion (Actual): April 9, 2024

Study Registration Dates

• First Submitted: June 22, 2026
• First Submitted That Met QC Criteria: June 26, 2026
• First Posted (Actual): June 30, 2026

Study Record Updates

• Last Update Posted (Actual): June 30, 2026
• Last Update Submitted That Met QC Criteria: June 26, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Transgender Persons; Gender Identity; Clinical Decision-Making.
• Other Study ID Numbers: CAEE 55339221.3.0000.5346

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be made publicly available because the study collected information from individual professionals under conditions of confidentiality and anonymity. Data sharing may be restricted by ethical and institutional requirements.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No