69 Assessing medical decision-making competence in transgender minors 4 Medical decision-making competence After the reference standard and MacCAT-T-based judgements, respectively, 93.2% (69 of 74) and 89.2% (66 of 74) of the adolescents were positive on MDC regarding starting PS. Table 6 shows characteristics of participants who were judged not competent. Table 6. Characteristics of participants judged not competent using the reference standard and/or MacCAT-T Participant Assigned sex Reference standard MacCAT-T Age (in years) Total IQ Duration of diagnostic trajectory (in months) 1 Female Incompetent Incompetent 12 69 7 2 Male Incompetent Incompetent 12 84 10 3 Female Competent Incompetent 11 93 15 4 Male Competent Incompetent 13 Missing 5 5 Male Competent Incompetent 12 96 12 6 Female Competent Incompetent 12 79 8 7 Female Competent Incompetent 17 66 10 8 Female Competent Incompetent 11 79 10 9 Female Incompetent Competent 11 Missing 7 10 Male Incompetent Competent 12 101 8 11 Female Incompetent Competent 10 110 13 Age refers to age at the informed consent session; total IQ refers to full-scale intelligence quotient. Intermethod agreement The reference standard and MacCAT-T-based judgements correlated in 87.8% (65 of 74) of the cases (table 7). Table 7. Percentage competent / incompetent according to the reference standard based judgements and the MacCAT-T based judgements of transgender adolescents’ medical decision-making competence MacCAT-T (n = 74) Reference standard (n = 74) Competent Incompetent Total Competent (n) 85.1% (63) 8.1% (6) 69 Incompetent (n) 4.1% (3) 2.7% (2) 5 Total 66 8 74 MacCAT-T refers to MacArthur Competence Assessment Tool for Treatment.
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