A Controlled Study of Psychological and Social Change after Surgical Gender Reassignment in Selected Male Transsexuals

Mate-Kole, C. Charles; Freschi, Maurizio; Robin, A. A.

doi:10.1192/bjp.157.2.261

Cited by 77 publications

(36 citation statements)

References 15 publications

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“…High percentages of psychiatric comorbidity, however, are not always found. In many studies, transsexuals were found to generally function well psychologically in the nonclinical range (e.g., Cole, O'Boyle, Emory, & Meyer, 1997;Gómez-Gil, Trilla, Salamero, Godás, & Valdés, 2009;Haraldsen & Dahl, 2000;Mate-Kole, Freschi, & Robin, 1990;Miach, Berah, Butcher, & Rouse, 2000;Seikowski, Gollek, Harth, & Reinhardt, 2008;Smith, van Goozen, & CohenKettenis, 2001;Smith et al, 2005). Indeed, clinically, one may see applicants who are employed, have relationships, and function socially without any problems, yet very strongly desire sex reassignment.…”

Section: The Necessity Of the D Criterion For A Gid Diagnosismentioning

confidence: 99%

The DSM Diagnostic Criteria for Gender Identity Disorder in Adolescents and Adults

2009

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Apart from some general issues related to the Gender Identity Disorder (GID) diagnosis, such as whether it should stay in the DSM-V or not, a number of problems specifically relate to the current criteria of the GID diagnosis for adolescents and adults. These problems concern the confusion caused by similarities and differences of the terms transsexualism and GID, the inability of the current criteria to capture the whole spectrum of gender variance phenomena, the potential risk of unnecessary physically invasive examinations to rule out intersex conditions (disorders of sex development), the necessity of the D criterion (distress and impairment), and the fact that the diagnosis still applies to those who already had hormonal and surgical treatment. If the diagnosis should not be deleted from the DSM, most of the criticism could be addressed in the DSM-V if the diagnosis would be renamed, the criteria would be adjusted in wording, and made more stringent. However, this would imply that the diagnosis would still be dichotomous and similar to earlier DSM versions. Another option is to follow a more dimensional approach, allowing for different degrees of gender dysphoria depending on the number of indicators. Considering the strong resistance against sexuality related specifiers, and the relative difficulty assessing sexual orientation in individuals pursuing hormonal and surgical interventions to change physical sex characteristics, it should be investigated whether other potentially relevant specifiers (e.g., onset age) are more appropriate.

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Section: The Necessity Of the D Criterion For A Gid Diagnosismentioning

confidence: 99%

The DSM Diagnostic Criteria for Gender Identity Disorder in Adolescents and Adults

2009

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“…The lengthy process is often cited as a contributory factor in the development of comorbid psychiatric problems, and untreated gender dysphoria can be associated with significant psychological distress and is a risk factor for suicide. 2 The costs of treatment need to be weighed up against the ongoing costs of supporting the mental healthcare needs of those awaiting genital surgery.…”

Section: Original Papersmentioning

confidence: 99%

“…1 The outcome of premorbid psychopathology following gender reassignment surgery is unclear. Mate-Kole et al 2 reported improvements in sexual functioning and neurotic symptoms, whereas Udeze et al 4 reported no significant effect on psychological functioning 6 months post-surgery. Following a successful appeal against a local health authority in 1999, 5 a blanket ban on funding of medical treatment for gender reassignment was deemed illegal and those diagnosed with gender identity disorder are entitled to appropriate treatment in the National Health Service (NHS).…”

mentioning

confidence: 99%

“…Treatment involving hormones and gender-confirming surgery has been associated with excellent social, sexual and psychological outcomes. 2 In the UK the Gender Recognition Act 2004 allows individuals to obtain legal recognition of their post-transition gender. Lifetime psychiatric comorbidity is high in people with gender identity disorder, 3 with 71% reported to have a current and/or lifetime Axis I disorder.…”

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confidence: 99%

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Gender reassignment: 5 years of referrals in Oxfordshire

Saunders¹,

Bass²

2011

Psychiatrist

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Aims and methodTo evaluate the characteristics of individuals seeking gender reassignment, the frequency of subsequent referrals to a specialist centre, and funding approval. Cases were identified from a local referrals database and data were extracted from case notes.ResultsFifty-four individuals attended for assessment; 70% were biological males and 30% were biological females. Mean age at referral was significantly different between the two groups. Over half were taking hormone supplementation and three had already had surgery. Further, 24% had a current and 30% a past mental illness. The majority of individuals were referred to a specialist centre for gender reassignment but only two had funding for surgery approved. Paedophilia was a rare but concerning finding.Clinical implicationsPsychiatric assessment plays an important role in confirming transsexualism and in identifying other relevant diagnoses.

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“…Patient satisfaction following SRS is high [3,4] and the reduction of gender dysphoria following SRS results in considerable psychological and social benefits [5,6]. As with all surgical interventions, the quality of care provided before, during, and after SRS has an important impact on patient outcomes [7].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic hysterectomy as the method of choice for hysterectomy in female-to-male gender dysphoric individuals

et al. 2008

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The objective of this paper was to report on a large series of laparoscopic hysterectomy in female-to-male (FTM) transsexual patients. A retrospective study was carried out by the gender team of Ghent University Hospital, Ghent, Belgium. The patient files of 83 consecutive cases of laparoscopic hysterectomy between April 2003 and August 2007 were reviewed and analyzed. The average operating time for the laparoscopic hysterectomy was 64 (30-150) min. The estimated blood loss for the laparoscopic hysterectomy averaged 86 (25-600) ml. We encountered two bladder perforations, which were immediately repaired, and one hematoma of the vaginal dome, which necessitated a second intervention. The serious complication rate of our series is 3.6%. Sex reassignment surgery (SRS) has proven to be the most effective treatment for patients with gender dysphoria. In FTM transsexual individuals, hysterectomy is an essential part of SRS. Since 2003, we have performed laparoscopic hysterectomy in conjunction with a subcutaneous mastectomy as a first step in SRS in FTM transsexual patients, thus, facilitating the transition for the patient and improving the operative planning for the different surgical teams. Laparoscopic hysterectomy has undoubtedly proven to be superior to abdominal hysterectomy regarding postoperative pain and recuperation, while it is as safe as the vaginal or abdominal route. We think that laparoscopic hysterectomy is the most appropriate method for hysterectomy in FTM transsexual patients.

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A Controlled Study of Psychological and Social Change after Surgical Gender Reassignment in Selected Male Transsexuals

Cited by 77 publications

References 15 publications

The DSM Diagnostic Criteria for Gender Identity Disorder in Adolescents and Adults

The DSM Diagnostic Criteria for Gender Identity Disorder in Adolescents and Adults

Gender reassignment: 5 years of referrals in Oxfordshire

Laparoscopic hysterectomy as the method of choice for hysterectomy in female-to-male gender dysphoric individuals

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