Development and validation of educational-assistance technology for self-care for pregnant trans men during prenatal care

Henrique, Matheus Emanuel de Castro; Clementino, Francisco de Sales; Avelino, Matheus Madson Lima; Cavalcante, Eliane Santos; Nascimento, Ellany Gurgel Cosme do; Pessoa Júnior, João Mário

doi:10.1590/1806-9304202500000142-en

person Matheus Emanuel de Castro Henrique

conceptualization · data analysis and interpretation · writing · declare no conflicts of interest

schoolDepartamento de Ciências da Saúde. Centro de Ciências da Saúde. Universidade Federal Rural do Semi-Árido. Mossoró, RN, Brazil

0009-0008-3366-9786

person Francisco de Sales Clementino

data interpretation and writing · declare no conflicts of interest

schoolUniversidade Federal de Campina Grande. Unidade Acadêmica de Enfermagem. Programa de Pós-graduação em Saúde Pública da Universidade Estadual da Paraíba. Campina Grande, PB, Brazil

0000-0001-8470-4694

person Matheus Madson Lima Avelino

conceptualization · analysis and review of the final version · declare no conflicts of interest

schoolPrograma de Pós-Graduação em Cognição, Tecnologias e Instituições. Universidade Federal Rural do Semi-Árido. Av. Francisco Mota, 572. Costa e Silva. Mossoró, RN, Brazil. CEP: 59.625-900. E-mail: joao.pessoa@ufersa.edu.br

0000-0002-1795-0403

person Eliane Santos Cavalcante

data interpretation · writing and review of the final version · declare no conflicts of interest

schoolEscola de Saúde. Centro de Ciências da Saúde. Universidade Federal do Rio Grande do Norte. Natal, RN, Brazil

0000-0002-0001-9161

person Ellany Gurgel Cosme do Nascimento

data interpretation · writing and review of the final version · declare no conflicts of interest

schoolPrograma de Pós-Graduação em Saúde e Sociedade. Faculdade de Ciências da Saúde. Universidade do Estado do Rio Grande do Norte. Mossoró, RN, Brazil

0000-0003-4014-6242

person João Mário Pessoa Júnior

conceptualization · data analysis and interpretation · writing and review of the final version · declare no conflicts of interest

schoolPrograma de Pós-Graduação em Cognição, Tecnologias e Instituições. Universidade Federal Rural do Semi-Árido. Av. Francisco Mota, 572. Costa e Silva. Mossoró, RN, Brazil. CEP: 59.625-900. E-mail: joao.pessoa@ufersa.edu.br

0000-0003-2458-6643

Associated Editor:

Leila Katz

Questionnaire Items	Judge 1	Judge 2	Judge 3	Judge 4	Judge 5	Judge 6	Judge 7	CVI
1. Adaptation of topics included in the Pregnant Women’s Booklet (Ministry of Health, 2022).	3	3	4	4	3	2	3	0.85
2. Inclusion of specific rights of transgender people in the topic “Know your rights” of the Booklet.	4	3	4	4	4	3	3	1
3. Inclusion of spaces for pregnant men to highlight their social names, their pronouns and whether previous rectification occurred or if they desire to rectify documents.	4	4	4	1	4	4	3	0.85
4. Inclusion of the topic: “Hormone therapy and Pregnancy”, which discusses cross-hormone therapy with exogenous testosterone during pregnancy.	4	4	4	4	4	3	4	1
5. Inclusion of the topic: “Resuming hormone therapy”, which discusses the effects of cross-hormone therapy with exogenous testosterone during breastfeeding and recommends the assisted resume, done by the healthcare team.	4	4	4	4	4	4	4	1
6. Inclusion of the topic: “Specific psychological aspects of pregnant trans men”, which discusses social gender dysphoria.	4	4	4	4	4	4	4	1
7. " Inclusion of a portfolio with photographic records of other transgender men during pregnancy, delivery and postpartum in the topic: “Specific psychological aspects of pregnant trans men”.	3	3	3	4	4	4	4	1
8. Inclusion of the topic: “Specific physical aspects of pregnant trans men”, which discusses gender dysphoria of physical type and strategies for its challenge.	3	4	4	4	4	4	4	1
9. Inclusion of the topic: “How to dress during pregnancy”, which discusses options of clothes adequate to the strategy of behavior in pregnancy chosen by trans men.	1	3	4	2	2	3	3	0.57
10. Inclusion of the topic: “Specific obstetric considerations”, which addresses the particularities of labor of transgender men.	4	4	4	4	4	4	4	1
11. Inclusion of the topic: “Trans men and breastfeeding”, which addresses the particularities of breastfeeding by transgender men, its benefits and recommendations for success in the process.	4	4	4	4	4	4	4	1
12. Inclusion of the topic: “Trans women and breastfeeding”, which addresses the possibility of inducing breastfeeding in transexual partners of pregnant men.	4	3	4	4	4	4	4	1
TOTAL CVI								0.94

Booklet Item	Suggestion	Modification
Cover	Only one image instead of two.	Reformulation of the cover according to the suggestion.
Language	During pregnancy, most men lose characteristics referred to as “masculine”, which may lead to discomfort. However, they are still trans men. We should not associate pregnancy to femininity only, which is also true for masculinity. The body changes during pregnancy and these changes should be supported during prenatal care, including the loss of masculine characteristics.	Adoption of a language, as far as possible, distant from gender poles.
Structure of the topic of identification of pregnant men	The name existent in the front of the booklet should be the social name, any rectification available on the background.	Exclusion of the space related to the desire of rectification of civil name and addition of a topic with guidelines of how to make it on their own.
Images	I consider it highly important, being careful to assess the availability of pictures and copyrights in order to avoid problems.	Review of copyrights of all images used in the booklet.
Topic with suggestions of clothes for transgender pregnant men	I believe that clothing should not interfere with the assistance neither is it an obstetrics or gynecological component of prenatal, being a decision of the patient based on his personal style, cultural concepts and how he feels comfortable.	Exclusion of the item due to the lack of scientific evidence.
	I believe that it should be discussed with pregnant trans people the relevance of the guideline for them and whether recommendations should be part of the consultation.	Exclusion of the item due to the lack of scientific evidence.
	Some studies relate tight clothes to Intrauterine Growth Restriction (IUGR), I would not recommend.	Exclusion of the item due to lack of scientific evidence.
General structure of the booklet	I missed the existence of a page with the registry of Monthly consultations with complaints, weight, BP, IA and FHR monitoring.	Inclusion of the session of registry of prenatal consultations present on the 2018 edition of the Pregnant Women’s Booklet of the Ministry of Health.

[tfn1] I-CVI = Item-level Validity Content Index; Total CVI = Total Content Validity Index.

Development and validation of educational-assistance technology for self-care for pregnant trans men during prenatal care

Abstract