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Background <p>Chinese transgender individuals seeking gender-affirming surgery (GAS) face legal, familial, and healthcare barriers, yet data on their psychological characteristics and surgical motivations remain limited. This exploratory study examined personality traits, defense styles, and self-reported motivations in a Chinese clinical sample.</p> Methods <p>In this cross-sectional study, 37 transgender individuals (transmasculine participants, <i>n</i> = 25; transfeminine participants, <i>n</i> = 12) completed the Eysenck Personality Questionnaire (EPQ), Defense Style Questionnaire (DSQ), and a self-developed GAS-related questionnaire. EPQ scores were compared with Chinese national normative values in an exploratory manner using Wilcoxon signed-rank tests. Associations between EPQ and DSQ dimensions were examined using Spearman correlations with false discovery rate correction. Findings from the self-developed questionnaire were analyzed descriptively.</p> Results <p>In exploratory comparisons with Chinese national norms, participants showed lower Extraversion (<i>p</i> &lt; 0.001), higher Neuroticism (<i>p</i> = 0.012), and higher Lie scores (<i>p</i> &lt; 0.001), while Psychoticism did not differ significantly (<i>p</i> = 0.976). After FDR correction, Neuroticism remained positively associated with immature defenses (ρ = 0.646, FDR-adjusted <i>p</i> &lt; 0.001), middle defenses (ρ = 0.468, FDR-adjusted <i>p</i> = 0.032), and hidden defenses (ρ = 0.428, FDR-adjusted <i>p</i> = 0.043). Descriptive questionnaire findings indicated that common motivations included enhancing self-confidence, changing the gender marker on official identification documents, and increasing social acceptance. Cronbach’s α was 0.82 for the Likert-type domains, with subscale values ranging from 0.78 to 0.85.</p> Conclusion <p>This exploratory study provides preliminary insights into personality traits, defense styles, and self-reported motivations among Chinese transgender individuals seeking GAS. The findings contribute context-specific descriptive data to the existing literature and may inform future research using larger, multicenter samples, appropriately matched comparison groups, and validated assessment instruments.</p>

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An exploratory study of preoperative psychological assessment for gender-affirming surgery: personality traits, defense mechanisms, and cultural factors in a chinese sample

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月21日

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  • Qianhui Xu,
  • Xian Wei,
  • Yakun Gao,
  • Lu Lu,
  • Hua Jiang,
  • Xiaohai Zhu,
  • Hui Wang

摘要

Background

Chinese transgender individuals seeking gender-affirming surgery (GAS) face legal, familial, and healthcare barriers, yet data on their psychological characteristics and surgical motivations remain limited. This exploratory study examined personality traits, defense styles, and self-reported motivations in a Chinese clinical sample.

Methods

In this cross-sectional study, 37 transgender individuals (transmasculine participants, n = 25; transfeminine participants, n = 12) completed the Eysenck Personality Questionnaire (EPQ), Defense Style Questionnaire (DSQ), and a self-developed GAS-related questionnaire. EPQ scores were compared with Chinese national normative values in an exploratory manner using Wilcoxon signed-rank tests. Associations between EPQ and DSQ dimensions were examined using Spearman correlations with false discovery rate correction. Findings from the self-developed questionnaire were analyzed descriptively.

Results

In exploratory comparisons with Chinese national norms, participants showed lower Extraversion (p < 0.001), higher Neuroticism (p = 0.012), and higher Lie scores (p < 0.001), while Psychoticism did not differ significantly (p = 0.976). After FDR correction, Neuroticism remained positively associated with immature defenses (ρ = 0.646, FDR-adjusted p < 0.001), middle defenses (ρ = 0.468, FDR-adjusted p = 0.032), and hidden defenses (ρ = 0.428, FDR-adjusted p = 0.043). Descriptive questionnaire findings indicated that common motivations included enhancing self-confidence, changing the gender marker on official identification documents, and increasing social acceptance. Cronbach’s α was 0.82 for the Likert-type domains, with subscale values ranging from 0.78 to 0.85.

Conclusion

This exploratory study provides preliminary insights into personality traits, defense styles, and self-reported motivations among Chinese transgender individuals seeking GAS. The findings contribute context-specific descriptive data to the existing literature and may inform future research using larger, multicenter samples, appropriately matched comparison groups, and validated assessment instruments.