Archives of Sexual Behavior

, Volume 43, Issue 8, pp 1535–1545 | Cite as

An Analysis of All Applications for Sex Reassignment Surgery in Sweden, 1960–2010: Prevalence, Incidence, and Regrets

  • Cecilia DhejneEmail author
  • Katarina Öberg
  • Stefan Arver
  • Mikael Landén
Original Paper


Incidence and prevalence of applications in Sweden for legal and surgical sex reassignment were examined over a 50-year period (1960–2010), including the legal and surgical reversal applications. A total of 767 people (289 natal females and 478 natal males) applied for legal and surgical sex reassignment. Out of these, 89 % (252 female-to-males [FM] and 429 male-to-females [MF]) received a new legal gender and underwent sex reassignment surgery (SRS). A total of 25 individuals (7 natal females and 18 natal males), equaling 3.3 %, were denied a new legal gender and SRS. The remaining withdrew their application, were on a waiting list for surgery, or were granted partial treatment. The incidence of applications was calculated and stratified over four periods between 1972 and 2010. The incidence increased significantly from 0.16 to 0.42/100,000/year (FM) and from 0.23 to 0.73/100,000/year (MF). The most pronounced increase occurred after 2000. The proportion of FM individuals 30 years or older at the time of application remained stable around 30 %. In contrast, the proportion of MF individuals 30 years or older increased from 37 % in the first decade to 60 % in the latter three decades. The point prevalence at December 2010 for individuals who applied for a new legal gender was for FM 1:13,120 and for MF 1:7,750. The FM:MF sex ratio fluctuated but was 1:1.66 for the whole study period. There were 15 (5 MF and 10 MF) regret applications corresponding to a 2.2 % regret rate for both sexes. There was a significant decline of regrets over the time period.


Transsexualism Gender identity disorder Gender dysphoria Incidence Prevalence Sex ratio 



The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Financial support was provided through the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and the Karolinska Institutet, through grants from the Royal Swedish Academy of Sciences (Torsten Amundson’s Foundation) and from the Clinical Department of Psychiatry Stockholm Health Care Services. We thank Linda Almqvist, at the time for data collection legal adviser at The National Board of Health and Welfare, Stockholm, Sweden for valuable assistance with data collection and administrative support. We also thank Dr. Gail Knudson, who generously commented on the article.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Cecilia Dhejne
    • 1
    • 2
    Email author
  • Katarina Öberg
    • 2
    • 3
  • Stefan Arver
    • 2
    • 3
  • Mikael Landén
    • 4
    • 5
  1. 1.Center for Psychiatric Research, Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
  2. 2.Center for Andrology and Sexual Medicine, C2:84Karolinska University HospitalStockholmSweden
  3. 3.Department of Medicine/HuddingeKarolinska InstitutetStockholmSweden
  4. 4.Institute of Neuroscience and PhysiologySahlgrenska University HospitalGothenburgSweden
  5. 5.Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden

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