Sex reassignment surgery in Europe: A survey

Acta Psychiatrica Scandinavica (Impact Factor: 5.61). 03/1987; 75(2):176-82. DOI: 10.1111/j.1600-0447.1987.tb02771.x
Source: PubMed


Since the first publications on a sex reassignment operation in Denmark in the early fifties, the European environment in which sex reassignment surgery (SRS) takes place has changed drastically. However the possibilities differ considerably between one country and another. To get a picture of the European situation a questionnaire was sent out to gender clinics and private practitioners treating transsexuals in 15 European countries. Questions were asked about evaluation of candidates for a treatment program, details of such programs, the legal and financial situation in the different countries and attitudes and place of psychotherapy in the SRS procedure. By and large there seems to be fairly good consensus within those European SRS treatment programs we had the opportunity to evaluate.

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Available from: Peggy T Cohen-Kettenis, Jan 22, 2015
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    ABSTRACT: The Harry Benjamin International Gender Dysphoria Association's Standards of Care (Walker et al., 1985) set out minimum standards for the selection of patients for sex reassignment surgery. This survey reports on the standard and policies actually used by clinics in Europe and North America, including their areas of agreement and disagreement with the Standards. To our knowledge, there has been only one prior survey of gender clinic policies, and that was restricted to European treatment facilities. The present survey is aimed at primary caregivers in the medical community; however, it may also be of use to administrators in responding to increasing demands for accountability from special interest groups and from government, with their often divergent agendas. It is our hope that this survey will begin the process of developing more uniform standards of care.
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    ABSTRACT: Transsexualism is considered to be the extreme end of the spectrum of gender identity disorders characterized by, among other things, a pursuit of sex reassignment surgery (SRS). The origins of transsexualism are still largely unclear. A first indication of anatomic brain differences between transsexuals and nontranssexuals has been found. Also, certain parental (rearing) factors seem to be associated with transsexualism. Some contradictory findings regarding etiology, psychopathology and success of SRS seem to be related to the fact that certain subtypes of transsexuals follow different developmental routes. The observations that psychotherapy is not helpful in altering a crystallized cross-gender identity and that certain transsexuals do not show severe psychopathology has led clinicians to adopt sex reassignment as a treatment option. In many countries, transsexuals are now treated according to the Standards of Care of the Harry Benjamin International Gender Dysphoria Association, a professional organization in the field of transsexualism. Research on postoperative functioning of transsexuals does not allow for unequivocal conclusions, but there is little doubt that sex reassignment substantially alleviates the suffering of transsexuals. However, SRS is no panacea. Psychotherapy may be needed to help transsexuals in adapting to the new situation or in dealing with issues that could not be addressed before treatment.
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