Long-term Assessment of the Physical, Mental, and Sexual Health among Transsexual Women

Department of Gynaecology, University Hospital of Ghent, Ghent, Belgium.
Journal of Sexual Medicine (Impact Factor: 3.15). 12/2008; 6(3):752-60. DOI: 10.1111/j.1743-6109.2008.01082.x
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Transsexualism is the most extreme form of gender identity disorder and most transsexuals eventually pursue sex reassignment surgery (SRS). In transsexual women, this comprises removal of the male reproductive organs, creation of a neovagina and clitoris, and often implantation of breast prostheses. Studies have shown good sexual satisfaction after transition. However, long-term follow-up data on physical, mental and sexual functioning are lacking.
To gather information on physical, mental, and sexual well-being, health-promoting behavior and satisfaction with gender-related body features of transsexual women who had undergone SRS.
Fifty transsexual women who had undergone SRS >or=6 months earlier were recruited.
Self-reported physical and mental health using the Dutch version of the Short-Form-36 (SF-36) Health Survey; sexual functioning using the Dutch version of the Female Sexual Function Index (FSFI). Satisfaction with gender-related bodily features as well as with perceived female appearance; importance of sex, relationship quality, necessity and advisability of gynecological exams, as well as health concerns and feelings of regret concerning transition were scored.
Compared with reference populations, transsexual women scored good on physical and mental level (SF-36). Gender-related bodily features were shown to be of high value. Appreciation of their appearance as perceived by others, as well as their own satisfaction with their self-image as women obtained a good score (8 and 9, respectively). However, sexual functioning as assessed through FSFI was suboptimal when compared with biological women, especially the sublevels concerning arousal, lubrication, and pain. Superior scores concerning sexual function were obtained in those transsexual women who were in a relationship and in heterosexuals.
Transsexual women function well on a physical, emotional, psychological and social level. With respect to sexuality, they suffer from specific difficulties, especially concerning arousal, lubrication, and pain.

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    • "Sexual functioning and sexual satisfaction assessed by FSFI was different in the study group according to the patient's sexual orientation, and markedly lower in transwomen with homosexual preference. As a generalized conclusion, authors stated that the modification of the FSFI questionnaire for the transwomen should be created to fully understand the sexual function and difficulties in transsexual women [56]. Psychological and psychosocial evaluation by structured interview and standardized questionnaires should be a part of this type of study. "
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    ABSTRACT: Transsexualism is a complex condition in which the person experiences the inconsistency between the desired gender and their biological gender. Absence of the vagina is devastating in male to female transsexuals. Creation of the neovagina is the main surgical problem in these patients. Historically, beginnings of the neovaginal creation have their roots in the treatment of Mayer-Rokitansky syndrome and conditions such as cloacal anomalies, certain intersex disorders, vaginal malignancies, or severe vaginal trauma, but have more recently found great purpose in male to female sex reassignment surgery. Many operative procedures have been described but none is ideal. Therefore, the search for new, improved solutions continues. In neovaginoplasty reconstruction of the vulvovaginal complex is performed in its entity. The gold standard in neovaginal reconstruction in male to female sex reassignment surgery is penile skin inversion technique with or without scrotal flaps, which enables adequate sensation of the neovagina, good neovaginal depth, good erotic sensitivity of the neclitoris, and esthetically acceptable labia minora and maiora.
    05/2014; 2014:638919. DOI:10.1155/2014/638919
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    • "The combination of greater general social support and higher relationship satisfaction predicted fewer symptoms of depression , stress and anxiety for trans participants in the current study. This finding aligns with previous literature highlighting the importance of having healthy romantic relationships and positive social support for trans and LGB persons (Blair & Holmberg, 2008; Kurdek, 2003, 2004; Weyers et al., 2009). "
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    ABSTRACT: The literature on the transgender/transsexual-spectrum persons is limited. Most studies are based on assumptions that trans persons are best understood within rigid and binary definitions of gender and sexuality and tend to focus on diagnostics, medical management and risk factors. Researchers and clinicians may assume that people who challenge cultural norms of gender and sexuality can be grouped together, which can result in harmful assumptions about the specific experiences of trans persons. The purpose of this study was to explore the gender and sexual identities of trans persons, investigate group differences, and examine factors that predict better psychological and physical well-being. Participants took part in an online study and provided information about their gender and sexual identity, social support, relationship quality, and mental/physical health. Results depicted diverse gender identities and sexual orientations among trans persons and emphasized that while many challenges faced by sexual and gender minorities are similar, trans persons report unique mental and physical health outcomes. Also, greater social support and relationship quality predicted mental, but not physical, health among trans persons. These results highlight the importance of acknowledging the complexity of trans identities and the key role of social and personal support.
    The Canadian journal of human sexuality 05/2014; in press. DOI:10.3138/cjhs.2378
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    • "In the past few decades , the literature has addressed trans - sexual patients ' quality of life , satisfaction and various other outcomes such as sexual functioning after sex reas - signment surgery ( Bonierbale et al . , 2004 ; Klein and Gor - zalka , 2009 ; Weyers et al . , 2009 ) . Few data are available regarding the role of hormonal therapy in the well - being of transsexual patients without sex reassignment surgery . How - ever , these data should provide relevant information for Table 4 Means , standard deviations and prevalence of symptoms of depression measured with SDS scale in transsexual patients befo"
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    ABSTRACT: The aim of the present study was to evaluate the presence of psychiatric diseases/symptoms in transsexual patients and to compare psychiatric distress related to the hormonal intervention in a one year follow-up assessment. We investigated 118 patients before starting the hormonal therapy and after about 12 months. We used the SCID-I to determine major mental disorders and functional impairment. We used the Zung Self-Rating Anxiety Scale (SAS) and the Zung Self-Rating Depression Scale (SDS) for evaluating self-reported anxiety and depression. We used the Symptom Checklist 90-R (SCL-90-R) for assessing self-reported global psychological symptoms. Seventeen patients (14%) had a DSM-IV-TR axis I psychiatric comorbidity. At enrollment the mean SAS score was above the normal range. The mean SDS and SCL-90-R scores were on the normal range except for SCL-90-R anxiety subscale. When treated, patients reported lower SAS, SDS and SCL-90-R scores, with statistically significant differences. Psychiatric distress and functional impairment were present in a significantly higher percentage of patients before starting the hormonal treatment than after 12 months (50% vs. 17% for anxiety; 42% vs. 23% for depression; 24% vs. 11% for psychological symptoms; 23% vs. 10% for functional impairment). The results revealed that the majority of transsexual patients have no psychiatric comorbidity, suggesting that transsexualism is not necessarily associated with severe comorbid psychiatric findings. The condition, however, seemed to be associated with subthreshold anxiety/depression, psychological symptoms and functional impairment. Moreover, treated patients reported less psychiatric distress. Therefore, hormonal treatment seemed to have a positive effect on transsexual patients’ mental health.
    Psychoneuroendocrinology 01/2014; 39(1):65–73. DOI:10.1016/j.psyneuen.2013.09.029 · 4.94 Impact Factor
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