Validation of the Gender Congruence and Life Satisfaction Scale (GCLS) among the Finnish population—implementing a tool to measure outcomes for transgender health services

Abstract

Background: Validated tools that can measure changes in gender dysphoria and are inclusive of all gender identities are needed. To date, there are no such tools that have been validated using the Finnish population. The aim was to perform a cross-cultural validation of the Gender Congruence and Life Satisfaction Scale (GCLS). Method: Data from the prospective 2019–2020 Helsinki Gender Identity Cohort (N = 773) were used to validate the GCLS for the Finnish population. The cohort individuals were asked to complete the GCLS and other validated psychological questionnaires as part of their clinical assessment and this register-based data were used. Confirmatory factor analysis (CFA) and Principal component analysis (PCA) were performed on the data to assess the factor structure of the GCLS in the Finnish cohort. Convergent validity of the GCLS was also evaluated. Results: The CFA did not show adequate fit and therefore PCA was conducted. The PCA recommended seven subscales with good internal consistency. Four factors related to gender congruence (genitalia, chest, social gender role recognition, other secondary sex characteristics), and three related to secondary outcomes (psychological well-being, social avoidance, and life satisfaction). The final three subscales factorized in a slightly different way in the Finnish cohort, compared to the seminal English validation of the GCLS. The correlation analysis showed good convergent validity of the factors retrieved by the PCA. Conclusion: The results show that the GCLS scale is a valid tool to measure dysphoria related to genitalia, chest, secondary sex characteristics, and social gender role recognition for the Finnish population.