Regret after Sex Reassignment Surgery in a Male-to-Female Transsexual: A Long-Term Follow-Up
This case report describes a four-decade presentation of a non-homosexual gender dysphoric male patient. The case material was collected from two main sources. One of the authors had weekly therapy sessions with the patient over a period of 2 years almost 15 years after sex reassignment surgery. Information was also gained from the patient's medical records covering the period from the early 1960s to the early 1990s. Over the years, the patient fulfilled the criteria for different diagnoses: overanxious reaction of childhood, fetishism and transvestism during adolescence, and transsexualism during adolescence and early adulthood. The purpose of this report was to shed light on aspects of regret, its manifestation in a male-to-female transsexual with psychiatric co-morbidity, and to show the complexity of the process of adjustment when regret is involved. The present case is an argument for a strict interpretation of the Standards of Care provided by the Harry Benjamin International Gender Dysphoria Association in terms of evaluating patients’ mental health, apart from the evaluation of the gender identity disorder, and the patients’ subsequent need for treatment interventions.
KEY WORDS:gender dysphoria gender identity disorder transsexualism sex reassignment surgery sexual orientation.
- American Psychiatric Association. (1968). Diagnostic and statistical manual of mental disorders (2nd ed.). Washington, DC: Author.Google Scholar
- American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.Google Scholar
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.Google Scholar
- Blanchard, R., Steiner, B. W., Clemmensen, L. H., & Dickey, R. (1989). Prediction of regrets in postoperative transsexuals. Canadian Journal of Psychiatry , 34, 43–45.Google Scholar
- Goodenough, F. (1975). Measurement of intelligence by drawings. New York: Arno Press.Google Scholar
- Landén, M. (1999). Transsexualism: Epidemiology, phenomenology, aetiology, regret after surgery and public attitudes. Academic dissertation, Institute of Clinical Neuroscience, Göteborg University, Göteborg, Sweden.Google Scholar
- Lindberg, B. J. (1950). Psycho-infantilism. Acta Psychiatrica Neurologica Scandinavica Suppl., 61, 1–126.Google Scholar
- Lundström, B., & Wålinder, J. (1985). Evaluation of candidates for sex reassignment. Nordisk Psykiatrisk Tidskrift, 39, 225–228.Google Scholar
- Terman, L. M., & Merril, M. A. (1960). Stanford-Binet intelligence scale. New York: Houghton Mifflin.Google Scholar
- Wålinder, J. (1967). Transsexualism: A study of forty-three cases. Göteborg, Sweden: Scandinavian University Books.Google Scholar
- Wålinder, J., Lundström, B., & Thuwe, I. (1978). Prognostic factors in the assessment of male transsexuals for sex reassignment. British Journal of Psychiatry, 132, 16–20.Google Scholar