Introduction Sexual function following genital sexual reassignment surgery (SRS) is an important outcome for many transsexuals, affecting the choice of surgical technique, satisfaction with surgery, and quality of life. However, compared to other outcome measures, little clinical and research attention has been given to sexual functioning following SRS. Aim To discuss the potential impact of cross-sex hormone therapy and SRS on sexual function and to summarize the published empirical research on postsurgical sexual functioning in male-to-female (MtF) and female-to-male (FtM) transsexuals. Methods Cross-sex hormone therapy and SRS techniques are outlined, the potential roles of cross-sex hormone therapy and SRS on sexual function are discussed, and peer-reviewed literature published in English on postoperative sexual functioning in MtF and FtM transsexuals is reviewed. Main Outcome Measures Sexual desire, sexual arousal, and ability to achieve orgasm following SRS. Results Contrary to early views, transsexualism does not appear to be associated with a hyposexual condition. In MtF transsexuals, rates of hypoactive sexual desire disorder (HSDD) are similar to those found in the general female population. In FtM transsexuals, sexual desire appears unequivocally to increase following SRS. Studies with MtF transsexuals have revealed not only vasocongestion, but also the secretion of fluid during sexual arousal. Research on sexual arousal in FtM transsexuals is sorely lacking, but at least one study indicates increased arousal following SRS. The most substantial literature on sexual functioning in postoperative transsexuals pertains to orgasm, with most reports indicating moderate to high rates of orgasmic functioning in both MtF and FtM transsexuals. Conclusions Based on the available literature, transsexuals appear to have adequate sexual functioning and/or high rates of sexual satisfaction following SRS. Further research is required to understand fully the effects of varying types and dosages of cross-sex hormone therapies and particular SRS techniques on sexual functioning.
Maltodextrin, modified starch, inulin, alginate, gum arabic, and combinations thereof were used as carrier agents for spray drying of carotenoid-rich goldenberry ( Physalis peruviana L.) juice and compared to cellobiose as an alternative carrier. Powders were analyzed with respect to particle size and morphology, yield, moisture content, cold water solubility, suspension stability, hygroscopicity, carotenoid encapsulation efficiency, and carotenoid retention during storage. A high initial carotenoid concentration after spray drying, a high encapsulation efficiency of 77.2%, and a slow carotenoid degradation kinetics favored the high carotenoid content of the cellobiose powder at the end of the storage. Cellobiose might protect the carotenoids from degradation processes by light exposure, high temperature, and oxygen due to a tighter particle crust and larger particle sizes. Therefore, cellobiose may be considered a potential carrier agent for the encapsulation of carotenoid-rich fruit juices.
Men and women have been seeking professional assistance to help control hypersexual urges and behaviors since the nineteenth century. Despite that the literature emphasizes that cases of hypersexuality are highly diverse with regard to clinical presentation and comorbid features, the major models for understanding and treating hypersexuality employ a “one size fits all” approach. That is, rather than identify which problematic behaviors might respond best to which interventions, existing approaches presume or assert without evidence that all cases of hypersexuality (however termed or defined) represent the same underlying problem and merit the same approach to intervention. The present article instead provides a typology of hypersexuality referrals that links individual clinical profiles or symptom clusters to individual treatment suggestions. Case vignettes are provided to illustrate the most common profiles of hypersexuality referral that presented to a large, hospital-based sexual behaviors clinic, including: (1) Paraphilic Hypersexuality, (2) Avoidant Masturbation, (3) Chronic Adultery, (4) Sexual Guilt, (5) the Designated Patient, and (6) better accounted for as a symptom of another condition.
Conflicting data exist regarding the sexual arousal patterns of post-operative male-to-female (MTF) women with Gender Identity Disorder. The purpose of this study was to examine objective and subjective aspects of the sexual arousal response using a vaginal photoplethysmograph. Fifteen MTF women viewed neutral and erotic audiovisual film segments while their blood flow patterns were monitored. Subjective measures of affect and sexual arousal were taken before and immediately after the films. There was a significant increase in self-reported subjective arousal, perceived genital arousal, perceived autonomic arousal, and positive affect; however, movement artefacts interfered with our assessment of the genital arousal response. MTF women reported both low levels of pain and low levels of awareness of the vaginal probe during testing. These data are discussed in the context of differences in pelvic musculature between natal and new women and have implications for future studies that aim to measure sexual arousal objectively in MTF women.Keywords: Gender identity disorder, male-to-female transsexual, sex reassignment surgery, vaginal photoplethysmography, sexual arousal Gender Identity Disorder (GID) is diagnosed when an individual experiences (1) a strong, persistent cross-gender identification (not merely a desire for any perceived cultural advantages of being the other sex), and (2) a significant discomfort with his or her sex or a sense of inappropriateness in the gender role of that sex (termed gender dysphoria) [1]. GID should be distinguished from Transvestic Fetishisma form of cross-dressing that the DSM-IV-TR describes as often being associated with intense sexual fantasies or sexual urges. In a small number of individuals with transvestic fetishism, there is also the persistent desire to live and dress permanently as the opposite sex, in which case the diagnosis becomes Transvestic Fetishism with Gender Dysphoria.Views on GID have changed considerably over the last three decades, from attempting to ''treat'' individuals with the disorder through various behavioural therapies [2,3], to focusing on quality of life via surgical techniques that preserve sexual function [4,5]. The Harry Benjamin International Gender Dysphoria Association was established in 1978 to provide Standards of Care for health professionals treating individuals with GID. According to the Standards of Care published in 1998 [6], Sex Reassignment Surgery (SRS) is considered to be ''effective. . .when prescribed or recommended by qualified practitioners, is medically indicated, and [is] medically necessary''. Research on the long-term results of SRS in individuals with GID includes studies examining physical function [7], psychological function [8], and satisfaction with surgery [9]. For example, a large retrospective study on 232 male-to-female (MTF) women at least one year following SRS indicated that 96% were happy with the surgical results and 97% experienced improved quality of life as a result [5]. Moreover, no individuals rep...
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