A Report from a Single Institute’s 14-Year Experience in Treatment of Male-to-Female Transsexuals

Abstract

Introduction Gender identity disorder or transsexualism is a complex clinical condition, and prevailing social context strongly impacts the form of its manifestations. Sex reassignment surgery (SRS) is the crucial step of a long and complex therapeutic process starting with preliminary psychiatric evaluation and culminating in definitive gender identity conversion. Aim The aim of our study is to arrive at a clinical and psychosocial profile of male-to-female transsexuals in Italy through analysis of their personal and clinical experience and evaluation of their postsurgical satisfaction levels SRS. Methods From January 1992 to September 2006, 163 male patients who had undergone gender-transforming surgery at our institution were requested to complete a patient satisfaction questionnaire. Main Outcome Measures The questionnaire consisted of 38 questions covering nine main topics: general data, employment status, family status, personal relationships, social and cultural aspects, presurgical preparation, surgical procedure, and postsurgical sex life and overall satisfaction. Results Average age was 31 years old. Seventy-two percent had a high educational level, and 63% were steadily employed. Half of the patients had contemplated suicide at some time in their lives before surgery and 4% had actually attempted suicide. Family and colleague emotional support levels were satisfactory. All patients had been adequately informed of surgical procedure beforehand. Eighty-nine percent engaged in postsurgical sexual activities. Seventy-five percent had a more satisfactory sex life after SRS, with main complications being pain during intercourse and lack of lubrication. Seventy-eight percent were satisfied with their neovagina’s esthetic appearance, whereas only 56% were satisfied with depth. Almost all of the patients were satisfied with their new sexual status and expressed no regrets. Conclusions Our patients’ high level of satisfaction was due to a combination of a well-conducted preoperative preparation program, competent surgical skills, and consistent postoperative follow-up.

“Completely out-at-sea” with “two-gender medicine”: A qualitative analysis of physician-side barriers to providing healthcare for transgender patients

“…Perspectives from the trans community demonstrate a similar concern over lack of information on long-term outcomes and potential complications of gender transitioning treatments [13]. The literature on patient satisfaction after surgical transitioning is not extensive, but suggests that patient regret is relatively minimal, with a prevalence ranging from 2-6 % depending on the procedure [33-35]. Clinical guidelines were seen as a way to address knowledge deficits in gender transitioning treatments and preventative screening, but were not without criticism.…”

Varied Reports of Adult Transgender Suicidality: Synthesizing and Describing the Peer-Reviewed and Gray Literature

“…2,3 Unfortunately, the applicability of these findings in guiding policy and future research is impacted by wide variation in the findings of suicidality rates. 4,5 For example, Xavier et al 6 report an attempt rate of 25% and an ideation rate of 65%, while Imbimbo et al 7 record rates of 3% and 50%, respectively. The current meta-synthesis attempts to address these discrepancies by measuring the overall variation across and averaging the suicidality rates within these studies.…”

Urogenital/pelvic pain in men

“…Imbimbo et al [16] reported on 163 male-tofemale patients operated on over a 17-year period. 89% engaged in postsurgical sexual activity with 75% having a more satisfactory sex life after surgery.…”