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Alongside the gradual increase in use of participatory technology assessment (PTA), a tool to democratize decision-making on controversial technologies, a growing body of literature on how to assess the impact of PTA has developed. A distinction can be made between two generations of impact assessment studies. The first generation includes evaluations of the effects of PTAs on the state as a bounded unit of political decision-making. The second generation of assessment studies acknowledges a wider range of loci to study impact. However, neither provides insights into how a PTA impacts the relationships between the multiple arenas of political influence and political judgment. This paper develops a framework for impact assessment from a dynamic, process-oriented perspective. It draws on the 'dynamics of contention' theory proposed by McAdam et al. in Dynamics of Contention (Cambridge University Press, 2001). The framework is applied to three cases of PTA on controversial medical technologies: xenotransplantation (in the Netherlands and Switzerland) and genetic testing (in Austria). [ABSTRACT FROM AUTHOR]