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
Source: PubMed

ABSTRACT 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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    ABSTRACT: IntroductionAlthough there is literature on sexuality in gender dysphoria, few studies have been done prior to genital sex reassignment surgery (SRS).AimsTo evaluate the perception of sexual QoL in gender-dysphoric patients before genital SRS and the possible factors associated to this perception.Methods The final sample consisted of 67 male-to-female and 36 female-to-male gender-dysphoric adults consecutively attended in a gender unit who had not undergone genital SRS; 39.8% was receiving cross-sex hormonal treatment, and 30.1% had undergone breast augmentation or reduction. Sexual QoL was assessed using the sexual activity facet of the World Health Organization Quality of Life (WHOQOL)-100. Sociodemographic (age, gender, partner relationship) and clinical data (being on hormonal treatment and having undergone any breast surgery) were recorded from the clinical records. Depressive symptoms were assessed using the negative feelings facet of the WHOQOL-100. Personality was assessed using the Revised NEO-Five Factor Inventory.Main Outcome MeasuresSexual QoL, negative feelings, hormonal treatment, partner relationship, personality.ResultsThe mean score of the sexual facet was 10.01 (standard deviation = 4.09). More than 50% of patients rated their sexual life as “poor/dissatisfied” or “very poor/very dissatisfied,” around a quarter rated it as “good/satisfied” or “very good/very satisfied,” and the rest had a neutral perception. Three variables were significantly associated with a better sexual QoL: less negative feelings (β = −0.356; P < 0.001), being on hormonal treatment (β = 0.216; P = 0.018), and having a partner (β = 0.206; P = 0.022). Age, sex, having undergone some breast surgery, and personality factors were not associated with their perception.Conclusion This study indicates that before genital SRS, about half of gender-dysphoric subjects perceived their sexual life as “poor/dissatisfied” or “very poor/very dissatisfied.” Moreover, receiving hormonal treatment, low negative feelings, and having a partner are related to a better subjective perception of sexual QoL. Bartolucci C, Gómez-Gil E, Salamero M, Esteva I, Zubiaurre L, Montejo AL, Molero F, and Guillamón A. Sexual quality of life in gender-dysphoric adults before genital sex reassignment surgery. J Sex Med **;**:**–**.
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