Skip to main content

Quality of life of individuals with and without facial feminization surgery or gender reassignment surgery



To determine the self-reported quality of life of male-to-female (MTF) transgendered individuals and how this quality of life is influenced by facial feminization and gender reassignment surgery.


Facial Feminization Surgery outcomes evaluation survey and the SF-36v2 quality of life survey were administered to male-to-female transgender individuals via the Internet and on paper. A total of 247 MTF participants were enrolled in the study.


Mental health-related quality of life was statistically diminished (P < 0.05) in transgendered women without surgical intervention compared to the general female population and transwomen who had gender reassignment surgery (GRS), facial feminization surgery (FFS), or both. There was no statistically significant difference in the mental health-related quality of life among transgendered women who had GRS, FFS, or both. Participants who had FFS scored statistically higher (P < 0.01) than those who did not in the FFS outcomes evaluation.


Transwomen have diminished mental health-related quality of life compared with the general female population. However, surgical treatments (e.g. FFS, GRS, or both) are associated with improved mental health-related quality of life.

This is a preview of subscription content, access via your institution.

Fig. 1


  1. 1.

    Alsarraf, R. (2002). Outcomes instruments in facial plastic surgery. Facial Plastic Surgery, 18(2), 77–86.

    Article  PubMed  Google Scholar 

  2. 2.

    American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., Text Revision (DSM-IV-TR)). Washington, DC: American Psychiatric Association.

  3. 3.

    Becking, A. G., Tuinzing, B., Hage, J. J., & Gooren, L. J. G. (2006). Facial corrections in male to female transsexuals: A preliminary report on 16 patients. Journal of Oral and Maxillofacial Surgery, 54, 413–418.

    Article  Google Scholar 

  4. 4.

    Kuhn, A., Bodmer, C., Stadlmayr, W., Kuhn, P., Mueller, M. D., & Birkhäuser, M. (2009). Quality of life 15 years after sex reassignment surgery for transsexualism. Fertility and Sterility, 92(5), 1685–1689.e3.

    Article  PubMed  Google Scholar 

  5. 5.

    Lawrence, A. A. (2003). Factors associated with satisfaction or regret following male-to-female sex reassignment surgery. Archives of Sexual Behavior, 32(4), 299–315.

    Article  PubMed  Google Scholar 

  6. 6.

    Newfield, E., Hart, S., Dibble, S., & Kohler, L. (2006). Female-to-male transgender quality of life. Quality of Life Research, 15, 1447–1457.

    Article  PubMed  Google Scholar 

  7. 7.

    Rakic, Z., Starcevic, V., Maric, J., & Kelin, K. (1996). The outcome of sex reassignment surgery in Belgrade: 32 patients of both sexes. Archives of Sexual Behavior, 25(5), 515–525.

    Article  CAS  PubMed  Google Scholar 

  8. 8.

    Rehman, J., Lazer, S., Benet, A. E., Schaefer, L. C., & Melman, A. (1999). The reported sex and surgery satisfactions of 28 postoperative male-to-female transsexual patients. Archives of Sexual Behavior, 28(1), 71–89.

    Article  CAS  PubMed  Google Scholar 

  9. 9.

    Spiegel, J. H. (2008). Challenges in care of the transgender patient seeking facial feminization surgery. Facial Plastic Surgery Clinics of North America, 16, 233–238.

    Article  PubMed  Google Scholar 

  10. 10.

    Ware, J. E., Kosinski, M., Bjorner, J. B., Turner-Bowker, D. M., Gandek, B., & Maruish, M. E. (2007). User’s manual for the SF-36v2™ health survey (2nd ed.). Lincoln, RI: QualityMetric Incorporated.

Download references

Author information



Corresponding author

Correspondence to Jeffrey H. Spiegel.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Ainsworth, T.A., Spiegel, J.H. Quality of life of individuals with and without facial feminization surgery or gender reassignment surgery. Qual Life Res 19, 1019–1024 (2010).

Download citation


  • Facial feminization surgery
  • MTF transgender
  • Quality of life
  • Gender reassignment surgery