Impact of Gender Identity on Dentists' Clinical Decision-Making

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.

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Key information

Conditions

Clinical Decision-making Gender Identity Transgender Persons

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Universidade Federal de Santa Maria

Santa Maria, Rio Grande do Sul, 97501-650, Brazil

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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.

Treatment and study plan

Clinical Case Scenario

Behavioral

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.

Primary outcomes

Treatment Recommendation for Posterior Tooth

Time frame: Immediately after questionnaire completion

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.
Treatment Recommendation for Anterior Tooth

Time frame: Immediately after questionnaire completion

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.

Sponsors and collaborators

Lead sponsor

Universidade Federal de Santa Maria

Other

Registry information

Official study title

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

Acronym: GID-CDM

Important dates

Study start: 2023
Primary completion: 2024
Study completion: 2024
First posted: Jun 30, 2026
Registry last updated: Jun 30, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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Completed