"Most of the existing studies on the impact of GCT have been retrospective in nature (Klein & Gorza-lka, 2009; Murad et al., 2010) and may therefore suffer from recall bias. Further, these studies may suffer from a cognitive dissonance effect, whereby respondents may evaluate the effect of the treatments as more positive. A pre- and post-measure of a behavior (e.g., masturbation frequency) may have given a more realistic representation. Few studies have assessed the sexual experiences of transgender persons who wish to, but did not yet receive treatment (for some exceptions, see Cerwenka, Nieder, Briken, et al., 2014;Cerwenka, Nieder, Cohen-Kettenis, et al., 2014). This group of transgender persons may have particular negative sexual experiences due to their yet unfulfilled desire for treatment (Cerwenka, Nieder, Brikenet al., 2014). Similarly, little research has focused on transgender persons who do not wish to undergo GCT (for a similar observation, see Bauer & Hammond, 2015), thereby ignoring a substantial subgroup of transgender people."
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