Quality of Life Research

, Volume 15, Issue 9, pp 1447–1457 | Cite as

Female-to-male transgender quality of life

  • Emily NewfieldEmail author
  • Stacey Hart
  • Suzanne Dibble
  • Lori Kohler



We evaluated health-related quality of life in female-to-male (FTM) transgender individuals, using the Short-Form 36-Question Health Survey version 2 (SF-36v2).


Using email, Internet bulletin boards, and postcards, we recruited individuals to an Internet site (, which contained a demographic survey and the SF36v2. We enrolled 446 FTM transgender and FTM transsexual participants, of which 384 were from the US.


Analysis of quality of life health concepts demonstrated statistically significant (p<0.01) diminished quality of life among the FTM transgender participants as compared to the US male and female population, particularly in regard to mental health. FTM transgender participants who received testosterone (67%) reported statistically significant higher quality of life scores (p<0.01) than those who had not received hormone therapy.


FTM transgender participants reported significantly reduced mental health-related quality of life and require additional focus to determine the cause of this distress. Providing this community with the hormonal care they request is associated with improved quality of life.


Female Female-to-male transgender Gender identity Internet Male Quality of life Transgender Transsexualism/psychology 



Female-to-male (FTM) transgender participants were labeled female at birth and choose to identify as male


The Harry Benjamin International Gender Dysphoria Association (HBIGDA) is a US-based professional association for individuals that provide services to the transgender community


Health-related quality of life (QOL) is a way of defining the level of functioning and perceived well-being in an individual


The Short Form 36-Item Questionnaire version 2 (SF36v2) is a health-related quality of life measurement tool containing 36 questions, that cover 8 domains of physical and mental health


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  1. 1.
    Braveman P, Gruskin S (2003) Poverty, equity, human rights and health. Bull World Health Organ 81(7):539–545PubMedGoogle Scholar
  2. 2.
    Clark M, Landers S, Linde R, Sperber J (2001) The GLBT Health Access Project: a state-funded effort to improve access to care. Am J Public Health 91(6):895–896PubMedGoogle Scholar
  3. 3.
    Harrell J, Hall S, Taliaferro J (2003) Physiological responses to racism and discrimination: an assessment of the evidence. Am J Public Health 93(2):243–248PubMedGoogle Scholar
  4. 4.
    Din-Dzietham R, Nembhardb W, R C, SK D (2004) Perceived stress following race-based discrimination at work is associated with hypertension in African–Americans. The metro Atlanta heart disease study, 1999–2001. Soc Sci Med 58(3):449–461PubMedCrossRefGoogle Scholar
  5. 5.
    Meyer III (Chairperson) W, Bockting W, Cohen-Kettenis P, et al. The standards of care for gender identity disorders – sixth version. IJT February 2001; 5(1)Google Scholar
  6. 6.
    Rakic Z, Starcevic V, Maric J, Kelin K (1996) The outcome of sex reassignment surgery in Belgrade: 32 patients of both sexes. Arch Sexual Behav 25(5):515–525CrossRefGoogle Scholar
  7. 7.
    Schlatterer K, Yassouridis A, von Werder K, Poland D, Kemper J, Stalla G (1998) A follow-up study for estimating the effectiveness of a cross-gender hormone substitution therapy on transsexual patients. Arch Sexual Behav 27(5):475–492CrossRefGoogle Scholar
  8. 8.
    Bodlund O, Kullgren G (1996) Transsexualism – general outcome and prognostic factors: a five-year follow-up study of nineteen transsexuals in the process of changing sex. Arch Sexual Behav 25(3):303–316CrossRefGoogle Scholar
  9. 9.
    Clements K, Wilkinson W, Kitano K, Marx R. HIV Prevention and Health Service Needs of the Transgender Community in San Francisco. Int J Transsexuality (1999): 3(1+2)Google Scholar
  10. 10.
    Kenagy G (2005) Transgender health: findings from two needs assessment studies in Philadelphia. Health Soc Work 30(1):19–26PubMedGoogle Scholar
  11. 11.
    Ware J, Snow K, Kosinski M. SF-36 Health Survey: Manual and Interpretation Guide. Lincoln, RI: Quality Metric Incorporated; 1993, 2002Google Scholar
  12. 12.
    Mustanski B (2001) Getting wired: exploiting the Internet for the collection of valid sexuality data. J Sex Res 38(4):292–301CrossRefGoogle Scholar
  13. 13.
    Bell D, Mangione C, Kahn CJ (2001) Randomized testing of alternative survey formats using anonymous volunteers on the World Wide Web. J Am Med Inform Assoc 8(6):616–620PubMedGoogle Scholar
  14. 14.
    Williams D, Neighbors H, Jackson J (2003) Racial/ethnic discrimination and health: findings from community studies. Am J Public Health 93(2):200–208PubMedCrossRefGoogle Scholar
  15. 15.
    van Kesteren P, Asscheman H, Megens J, Gooren L (1997) Mortality and morbidity in transsexual subjects treated with cross-sex hormones. Clin Endocrinol 47:337–342CrossRefGoogle Scholar
  16. 16.
    Fitzpatrick K, Euton S, Jones J, Schmidt N (2005) Gender role, sexual orientation, and suicide risk. J Affect Disord 87(1):35–42PubMedCrossRefGoogle Scholar
  17. 17.
    Ware J, Kosinski M, Dewey J. How to Score Version 2 of the SF-36 Health Survey. Lincoln, RI: QualityMetric Incorporated; 2000Google Scholar
  18. 18.
    Zahran H, Kobau R, Moriarty D, Zack M, Giles W, Lando J. Self-Reported Frequent Mental Distress Among Adults – United States, 1993–2001. Atlanta: Centers for Disease Control and Prevention; 2004 October 22Google Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Emily Newfield
    • 1
    • 5
    Email author
  • Stacey Hart
    • 2
  • Suzanne Dibble
    • 3
  • Lori Kohler
    • 4
  1. 1.School of MedicineUniversity of CaliforniaSan FranciscoUSA
  2. 2.Department of PsychiatryUniversity of CaliforniaSan FranciscoUSA
  3. 3.Institute for Health and AgingUniversity of CaliforniaSan FranciscoUSA
  4. 4.Department of Family and Community MedicineUniversity of CaliforniaSan FranciscoUSA
  5. 5.School of MedicineUniversity of CaliforniaSan FranciscoUSA

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