Advertisement

Management of Patients with Gender Dysphoria

  • Alexandru E. Benet
  • Arnold Melman

Abstract

Gender dysphoria refers to dissatisfaction with one’s own anatomical gender and the desire to possess the secondary sexual characteristics of the opposite sex.1 Persons who express this desire are called transsexuals and represent the extreme of the spectrum of subjective dissatisfaction with assigned anatomy and societally sanctioned gender roles. The term transsexual is used to refer to both pre- and postoperative men and women who perceive their identity as incongruous with the anatomical reality and actively seek to resolve the conflict through sex-reassignment surgery. Once surgery is completed, however, and the new sexual identity is achieved, male or female is the preferred term.

Keywords

None None Gender Dysphoria Ethinyl Estradiol Scrotal Skin Glans Penis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Reference

  1. 1.
    Fisk NM. Gender Dysphoria Syndrome. Palo Alto: Stanford University Press; 1973.Google Scholar
  2. 2.
    Green RL. Transsexualism: mythological, historical, and cross cultural aspects. In: Benjamin H, ed. The Transsexual Phenomenon. New York: Julian Press; 1966: 173–186.Google Scholar
  3. 3.
    Brown GR. A review of clinical approaches to gender dysphoria [review]. J Clin Psychiatry 1990; 51: 57–64.PubMedGoogle Scholar
  4. 4.
    Bullough VL. Transsexualism in history. Arch Sex Behav 1975; 4: 561–571.PubMedCrossRefGoogle Scholar
  5. 5.
    Forgey D. The institution of bedarche among the North American Plains Indians J Sex Res 1975; 11: 1–5CrossRefGoogle Scholar
  6. 6.
    Wames H, Hill G. Gender indentity and the wish to be a woman Psychosomatics 1974; 15: 25–29.Google Scholar
  7. 7.
    Money J, DePriest M. Three cases of genital self-surgery and their relationship to transsexualism. J Sex Res 1976; 12: 283–294.PubMedCrossRefGoogle Scholar
  8. 8.
    Abraham F. Genitalumwandlung an zwei männlichten transvestiten. Z Sexualwissenschalft 1931; 18: 223–226.Google Scholar
  9. 9.
    Hoyer N. Man into Woman. New York: Dutton; 1993.Google Scholar
  10. 10.
    Benjamin H. Transsexualism and transvestism as psychosomatic and somato-psychic syndromes: symposium. Am J Psychother 1954; 8: 219–230.PubMedGoogle Scholar
  11. 11.
    Benjamin H. Nature and management of transsexualism with report on 31 operated cases. West J Surg Obstet Gynecol 1964; 72: 105–111.PubMedGoogle Scholar
  12. 12.
    Benjamin H. The Transsexual Phenomenon. New York: Julian Press; 1966.Google Scholar
  13. 13.
    Jorgenson C. A Personal Autobiography. New York: Paul E. Ericson; 1967.Google Scholar
  14. 14.
    Hamburger C. Desire for change of sex as shown by personal letters from 465 men and women. Acta Endocrinol (Copenh) 1953; 14: 361–375.Google Scholar
  15. 15.
    Volkin V. Transsexualism: as examined from the viewpoint of internalized object relations. In: Karasu TB, Socarides CW, eds. On Sexuality: Psychoanalytic Observations. New York: International Universities Press; 1979: 189–221.Google Scholar
  16. 16.
    Money J, Ehrhardt AA. [Transsexuals after the change of sex. Experiences and findings in Johns Hopkins Hospital]. [German]. Beitr Sexualforsch 1970; 49: 70–87.PubMedGoogle Scholar
  17. 17.
    Stoller RJ. A biased view of “sex transformation” operations. An editorial. J Nery Ment Dis 1969; 149: 312–317.CrossRefGoogle Scholar
  18. 18.
    Hastings D. Inauguration of a research project on transsexualism in a university medical center. In: Green R, Money J, eds. Transsexualism and Sex Reassignment. Baltimore: Johns Hopkins University Press; 1969: 243–251.Google Scholar
  19. 19.
    Pauly IB. The current status of the change of sex operation. J Nery Ment Dis 1968; 147: 460–471.CrossRefGoogle Scholar
  20. 20.
    Arieff A. Five Year Studies of Transsexuals: Psychiatric, Psychological and Surgical Aspects. Stanford: University Press; 1973.Google Scholar
  21. 21.
    Hastings D, Markland C. Post-surgical adjustment of twenty-five transsexuals (male-tofemale) in the University of Minnesota study. Arch Sex Behav 1978; 7: 327–336.PubMedCrossRefGoogle Scholar
  22. 22.
    Laub DR, Fisk N. A rehabilitation program for gender dysphoria syndrome by surgical sex change. Plast Reconstr Surg 1974; 53: 388–403.PubMedCrossRefGoogle Scholar
  23. 23.
    Edgerton MT, Knorr NJ, Callison JR. The surgical treatment of transsexual patients. Limitations and indications Plast Reconstr Surg 1970; 45: 38–46.PubMedCrossRefGoogle Scholar
  24. 24.
    Edgerton MT. The surgical treatment of male transsexuals [review]. Clin Plast Surg 1974; 1: 285–323.PubMedGoogle Scholar
  25. 25.
    Berger J, Green R, Laub D, et al. Standards of Care: The Hormonal and Surgical Reassignment of Gender Sex Dysphoric Persons. Galveston, TX: University of Texas Medical Branch, Janus Information Center; 1977.Google Scholar
  26. 26.
    Hertoft P, Sorensen T. Transsexuality: some remarks based on clinical experience. Ciba Found Symp 1978; 62: 165–181.PubMedGoogle Scholar
  27. 27.
    Sorensen T, Hertoft P. Sex modifying operations on transsexuals in Denmark in the period 1950–1977. Acta Psychiatr Scand 1980; 61: 56–66.PubMedCrossRefGoogle Scholar
  28. 28.
    Roberto L. Issues in diagnosis and treatment of transsexualism. Arch Sex Behav 1983; 12: 445–473.PubMedCrossRefGoogle Scholar
  29. 29.
    Bakker A, van Kesterene PJ, Gooren LJ, et al. The prevalence of transsexualism in The Netherlands. Acta Psychiatr Scand 1993; 87: 237–238.PubMedCrossRefGoogle Scholar
  30. 30.
    Ross MJ, Walinder J, Lundstrom B, et al. Cross-cultural approaches to transsexualism• a comparison between Sweden and Australia. Acta Psychiatr Scand 1981; 63: 75–82.PubMedCrossRefGoogle Scholar
  31. 31.
    Tsoi WF. The prevalence of transsexualism in Singapore. Acta Psychiatr Scand 1988; 78: 501–504.PubMedCrossRefGoogle Scholar
  32. 32.
    Engel H, Pfafflin F, Wiedeking C. H-Y antigen in transsexuality. Hum Genet 1980; 55: 315–319.PubMedCrossRefGoogle Scholar
  33. 33.
    Hoening J. Etiological research in transsexualism. Psychiatr J Univ Ottawa 1981; 6: 184–189.Google Scholar
  34. 34.
    Meyer-Bahlburg HFL, Grisanti GC, Ehrhardt AA. Prenatal effects of sex hormones on human male behavior: medroxyprogesterone acetate (MPA). Psychoneuroendocrinology 1977; 2: 383–390.PubMedCrossRefGoogle Scholar
  35. 35.
    Gooren L. The neuroendocrine response of leutinizing hormone to estrogen administration in heterosexual, homosexual, and transsexual subjects. J Clin Endocrinol Metab 1986; 63: 583–588.PubMedCrossRefGoogle Scholar
  36. 36.
    Rekers GA, Mead SL, Rosen AC Family correlates of male childhood gender disturbance. J Genet Psychol 1983; 142: 31–42.PubMedCrossRefGoogle Scholar
  37. 37.
    Stoller RJ. The Transsexual Experiment. New York: Jason Aronson; 1975.Google Scholar
  38. 38.
    Socarides CW. The desire for sexual transformation: a psychiatric evaluation of transsexualism. Am J Psychiatry 1969; 125: 1419–1425.PubMedGoogle Scholar
  39. 39.
    Forester BM, Swiller H. Transsexualism: review of syndrome and presentation of possible successful therapeutic approach. Int J Group Psychother 1972; 22: 343–351.PubMedGoogle Scholar
  40. 40.
    Bentler PM. A typology of transsexualism: gender identity theory and data. Arch Sex Behav 1976; 5: 567–584.PubMedCrossRefGoogle Scholar
  41. 41.
    Davenport CW. A follow-up study of 10 feminine boys. Arch Sex Behav 1986; 15: 511–517.PubMedCrossRefGoogle Scholar
  42. 42.
    Green R. Gender identity in childhood and later sexual orientation: follow-up of 78 males. Am J Psychiatry 1985; 142: 339–341.PubMedGoogle Scholar
  43. 43.
    Green R. Sexual Identity Conflict in Children and Adults. New York: Basic Books; 1974.Google Scholar
  44. 44.
    Brown GR. Bioethical issues in the management of gender dysphoria. Jefferson J Psychiatry 1988; 6: 23–24.Google Scholar
  45. 45.
    Stoller RM. On the Development of Masculinity and Femininity. New York: Science House; 1968.Google Scholar
  46. 46.
    Money J. Sex reassignment as related to hermaphroditism and transsexualism. In: Green R, Money J, eds. Transsexualism and Sex Reassignment. Baltimore: Johns Hopkins University Press; 1969: 91–113.Google Scholar
  47. 47.
    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. Washington, DC: American Psychiatric Association; 1980.Google Scholar
  48. 48.
    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed., revised ed. Washington, DC: American Psychiatric Association; 1987.Google Scholar
  49. 49.
    Meyer WJ, Webb A, Stuart CA. Physical and hormonal evaluation of transsexual patients: a longitudinal study. Arch Sex Behav 1986; 15: 121–138.PubMedCrossRefGoogle Scholar
  50. 50.
    Transsexualism and character disorders. 10th International Symposium on Gender Dysphoria, June 9–12, 1987, Amsterdam, the Netherlands.Google Scholar
  51. 51.
    Lothstein LM, Levine SB. Expressive psychotherapy with gender dysphoric patients. Arch Gen Psychiatry 1981; 38: 924–929.PubMedCrossRefGoogle Scholar
  52. 52.
    Meyer WJ, Walker PA, Suplee ZR. A survey of transsexual hormonal treatment in twenty gender-treatment centers. J Sex Res 1981; 17: 344–349.CrossRefGoogle Scholar
  53. 53.
    Fortin CJ, Klein T, Messmore HL, et al. Myocardial infarction and severe thromboembolic complications. As seen in an estrogen-dependent transsexual. Arch Intern Med 1984; 144: 1082–1083.PubMedCrossRefGoogle Scholar
  54. 54.
    Steiner B. Gender Dysphoria: Development, Research, Management. New York: Plenum Press; 1985.CrossRefGoogle Scholar
  55. 55.
    Mclndoe A. Treatment of congenital absence and obliterative conditions of vagina. Br J Plast Surg 1950; 2: 254–267.Google Scholar
  56. 56.
    Edgerton MT, Bull J. Surgical construction of the vagina and labia in male transsexuals. Plast Reconstr Surg 1970; 46: 529–539.PubMedCrossRefGoogle Scholar
  57. 57.
    Pandya NJ, Stuteville OH. A one-stage technique for constructing female external genitalia in male transsexuals. Br J Plast Surg 1973; 26: 277–282.PubMedCrossRefGoogle Scholar
  58. 58.
    Granato RC. Surgical approach to male transsexualism. Urology 1974; 3: 792–796.PubMedCrossRefGoogle Scholar
  59. 59.
    Markland C, Hastings D. Vaginal reconstruction using bowel segments in male-to-female transsexual patients. Arch Sex Behav 1978; 7: 305–307.PubMedCrossRefGoogle Scholar
  60. 60.
    Goligher JC. The use of pedicled transplants of sigmoid or other parts of the intestine for vaginal construction. Ann R Coll Surg Engl 1983; 65: 353–355.PubMedGoogle Scholar
  61. 61.
    Fortunoff S, Lattimer JK, Edson M. Vaginoplasty technique for female pseudohermaphrodites. Surg Gynecol Obstet 1964; 118: 545–548.PubMedGoogle Scholar
  62. 62.
    Malloy TR, Noone RB, Morgan AJ. Experience with the 1-stage surgical approach for constructing female genitalia in male transsexuals. J Urol 1976; 116: 335–337.PubMedGoogle Scholar
  63. 63.
    Rubin SO. A method of preserving the glans penis as a clitoris in sex conversion operations in male transsexuals. Scand J Urol Nephrol 1980; 14: 215–217.PubMedCrossRefGoogle Scholar
  64. 64.
    Young HH. Cure of cancer of prostate by radical perineal prostatectomy (prostato seminal vesiculectomy): history, literature and statistics of Young’s operation. J Urol 1945; 53: 188–252.Google Scholar
  65. 65.
    Belt E. Radical perineal prostatectomy in early carcinoma of the prostate. J Urol 1942; 48: 287–297.Google Scholar
  66. 66.
    Meyer R, Kesselring UK. One-state reconstruction of the vagina with penile skin as an island flap in male transsexuals. Plast Reconstr Surg 1980; 66: 401–406.PubMedGoogle Scholar
  67. 67.
    Hage JJ, Karim RB, Bloem JJ, et al. Sculpturing the neoclitoris in vaginoplasty for maleto-female transsexuals [review]. Plast Reconstr Surg 1994; 93: 358–364.PubMedGoogle Scholar
  68. 68.
    Jayaram BN, Stuteville OH, Bush IM. Complications and undesirable results of sex-reassignment surgery in male-to-female transsexuals. Arch Sex Behav 1978; 7: 337–345.PubMedCrossRefGoogle Scholar
  69. 69.
    Noe JM, Sato R, Coleman C, et al. Construction of male genitalia: the Stanford experience. Arch Sex Behav 1978; 7: 297–303.PubMedCrossRefGoogle Scholar
  70. 70.
    Green R, Fleming D. Transsexual surgery follow-up status in the 1990’s. Annu Revi Sex Res 1990; 1: 163–174.Google Scholar
  71. 71.
    Gregory J, Purcell M. Transsexualism. Philadelphia: B.C. Decker; 1987.Google Scholar
  72. 72.
    Meyer JK, Reter DJ. Sex reassignment. Follow-up. Archi Gen Psychiatry 1979; 36: 1010–1015.CrossRefGoogle Scholar
  73. 73.
    Hunt DD, Hampson JL. Transsexualism: a standardized psychological rating format for the evaluation of results of sex reassignemt surgery. Arch Sex Behav 1988; 9: 255–263.CrossRefGoogle Scholar
  74. 74.
    Pfafflin F. Regrets after sex reassignment surgery in gender dysphoria. In: Bockting WO, Coleman E, eds. Interdisciplinary Approaches in Clinical Management. Binghamton: Haworth Press; 1992: 69–85.Google Scholar
  75. 75.
    Abramowitz S. Psychosocial outcomes of sex reassignment surgery. J Consult Clin Psychol 1986; 4: 183–189.Google Scholar
  76. 76.
    Pfafflin F, Junge A. Nachuntersuchungen nach Geschlechusumwandlung: Eine kemmentierte Literatureubersicht 1961–1991 [Follow-up studies after sex-reassignment surgery: a review 1961–1991]. In: Pfafflin F, Junge A, eds. Geschlechusumwandlung: Abhanddlungen zur Transsexualitat [Sex change studies on transsexualism]. Stuttgart: Schattauer; 1992: 149–459.Google Scholar
  77. 77.
    Schaefer LC, Wheller CC. Harry Benjamin’s first ten cases (1938–1953): a clinical historical note. Arch Sex Behav 1995; 24: 73–93.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • Alexandru E. Benet
  • Arnold Melman

There are no affiliations available

Personalised recommendations