Abstract
Thirteen male-to-female transsexuals were investigated in an intensive interview study. The follow-up period varied between 6 and 25 years, with an average of 12 years. Surgical outcome was disappointing, and only one-third of the patients where a vaginal construction was carried out had a functioning vagina. The importance of patient cooperation postoperatively is pointed out and reasons for noncooperation are discussed. The generally held view of transsexuals as hypo- or asexual is questionned. In this study, one-third of the patients were very active sexually both before and after radical genital surgery. More than half of these castrated and estrogen-treated former males experienced orgasm, but only one-third were judged as having a fair or good sexual adjustment after sex reassignment. The possibility of unsuccessful surgical results must continue to be an important part of presurgery reality orientation both in doctors and patients. One striking finding is that overall sexual adjustment is often unchanged by genital surgery. Psychosocial adjustment showed a slight improvement after surgery. However, the majority of patients (eight) were judged to be unchanged. Repentance was chosen as the most crucial single outcome variable. One patient had officially requested reversal of sex change and another three were judged as repenting surgery in more indirect ways. Thus for a total of four individuals (30%), sex reassignment was considered retrospectively to be a mistake. Despite their returning to a male social role after surgery, however, two of the repenting patients were judged as fairly well adjusted from a psychosocial point of view.
Similar content being viewed by others
References
Edgerton, M. T., Knorr, N. J., and Callison, J. R. (1970). The surgical treatment of transsexual patients. Limitations and indications.Plast. Reconst. Surg. 45: 38–46.
Foerster, D. W., and Reynolds, C. L. (1979). Construction of natural appearing female genitalia in the male transsexual.Plast. Reconst. Surg. 64: 306–312.
Guze, H. (1969). Psychosocial adjustment of transsexuals: An evaluation and theoretical formulation. In Green, R., and Money, J. (eds.),Transsexualism and Sex Reassignment. Johns Hopkins, Baltimore.
Hamburger, C., Stürup, G. K., and Dahl-Iversen, E. (1953). Transvestitism.Nord. Med. 12: 844–848.
Hastings, D. (1974). Postsurgical adjustment of male transsexual patients.Clin. Plast. Surg. 1: 335–344.
Heim, N. (1981). Sexual behavior of castrated sex offenders.Arch. Sex. Behav. 10: 11–19.
Hertz, J., Tillinger, K.-G., and Westman, A. (1961). Transvestitism.Acta Psychiat. Scand. 37: 283–294.
Hunt, D. D., and Hampson, J. L. (1980). Follow-up of 17 biologic male transsexuals after sexreassignment surgery.Am. J. Psychiat. 137: 432–438.
Laub, D. R., and Fisk, N. (1974). A rehabilitation program for gender dysphoria syndrome by surgical sex change.Plast. Reconst. Surg. 53: 388–403.
Levine, S. B., and Lothstein, L. (1981). Transsexualism or the gender dysphoria syndromes.J. Sex Marital Ther. 7: 85–113.
Lundström, B. (1981). Gender dysphoria.A Social-Psychiatric Follow-Up Study of 31 Cases Not Accepted for Sex Reassignment. Scandinavian University Books, Akademiförlaget, Gothenburg, Sweden.
McIndoe, A. (1950). The treatment of congenital absence and obliterative conditions of the vagina.Brit. J. Plast. Surg. 2: 254–266.
Ohlsen, L., and Vedung, S. (1981). Skoog's technique for constructing female genitalia in the male transsexual developed in 24 operated cases.Chir. Plastica 6: 1–16.
Pauly, I. B. (1981). Outcome of sex reassignment surgery for transsexuals.Austral. New Zeal. J. Psychiat. 15: 45–51.
Person, E., and Ovesey, L. (1974). The transsexual syndrome in males. I. Primary transsexualism.Am. J. Psychother. 28: 174–193.
Pomeroy, W. B. (1969). Transsexualism and sexuality: Sexual behavior of pre- and postoperative male transsexuals. In Green, R., and Money, J. (eds.),Transsexualism and Sex Reassignment. Johns Hopkins, Baltimore.
Randell, J. (1969). Preoperative and postoperative status of male and female transsexuals. In Green, R., and Money, J. (eds.),Transsexualism and Sex Reassignment. Johns Hopkins, Baltimore.
Rubin, S.-O. (1980). A method of preserving the glans penis as a clitoris in sex conversion operations in male transsexuals.Scand. J. Urol. Nephrol. 14: 215–217.
Sörensen, T. (1981). A follow-up study of operated transsexual males.Acta Psychiat. Scand. 63: 486–503.
Stoller, R. J. (1975).Sex and Gender: Vol. 2. The Transsexual Experiment. Jason Aronson, New York.
Stürup, G. K. (1976). Male transsexuals. A long-term follow-up after sex reassignment operations.Acta Psychiat. Scand. 53: 51–63.
Wålinder, J. (1967).Transsexualism. Scandinavian University Books, Akademiförlaget, Gothenburg, Sweden.
Wålinder, J., and Thuwe, I. (1975).A Social-Psychiatric Follow-Up Study of 24 Sex-Reassigned Transsexuals. Scandinavian University Books, Akademiförlaget, Gothenburg, Sweden.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lindemalm, G., Körlin, D. & Uddenberg, N. Long-term follow-up of “sex change” in 13 male-to-female transsexuals. Arch Sex Behav 15, 187–210 (1986). https://doi.org/10.1007/BF01542412
Issue Date:
DOI: https://doi.org/10.1007/BF01542412