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The transsexual: what about the future?

Published online by Cambridge University Press:  16 April 2020

A. Michel ,
M. Ansseau ,
J.J. Legros ,
W. Pitchot  and
C. Mormont
A. Michel*
Affiliation:
Department of Clinical Psychology, University of Liege, Boulevard du Rectorat – B33, 4000Liege, Belgium
M. Ansseau
Affiliation:
Department of Psychiatry, University of Liege, Boulevard du Rectorat – B33, 4000Liege, Belgium
J.J. Legros
Affiliation:
Department of Psychoneuroendocrinology, University of Liege, Boulevard du Rectorat – B33, 4000Liege, Belgium
W. Pitchot
Affiliation:
Department of Psychiatry, University of Liege, Boulevard du Rectorat – B33, 4000Liege, Belgium
C. Mormont
Affiliation:
Department of Clinical Psychology, University of Liege, Boulevard du Rectorat – B33, 4000Liege, Belgium
*
*E-mail address:aude.michel@tiscali.fr (A. Michel).
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Summary

Since the 1950s, sexual surgical reassignments have been frequently carried out. As this surgical therapeutic procedure is controversial, it seems important to explore the actual consequences of such an intervention and objectively evaluate its relevance. In this context, we have carried out a review of the literature. After looking at the methodological limitations of follow-up studies, the psychological, sexual, social, and professional futures of the individuals subject to a transsexual operation are presented. Finally, prognostic aspects are considered. In the literature, follow-up studies tend to show that surgical transformations have positive consequences for the subjects. In the majority of cases, transsexuals are very satisfied with their intervention and any difficulties experienced are often temporary and disappear within a year after the surgical transformation. Studies show that there is less than 1% of regrets, and a little more than 1% of suicides among operated subjects. The empirical research does not confirm the opinion that suicide is strongly associated with surgical transformation.

Keywords

TranssexualismFollow-upLiterature review
Type
Original Article
Information
European Psychiatry , Volume 17 , Issue 6 , October 2002 , pp. 353 - 362
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2002

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References

Abramowitz, SI. Psychosocial outcome of sex reassignment surgery. J Consult Clin Psychol 1986;54:183–9.CrossRefGoogle Scholar
Alanko, AAchté, KA. Transsexualism. Psychiatrica 1971:343–58.Google Scholar
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 3rd ed. Paris: Masson; 1980.Google Scholar
Beatrice, J. A psychological comparison of heterosexuals, transvestites, preoperative transsexuals, and postoperative transsexuals. J Nerv et Ment Dis 1985; 173;358–65.CrossRefGoogle ScholarPubMed
Benjamin, H. Clinical aspects of transsexualism in males and females. Am J Psychother 1964;11:458–69.CrossRefGoogle Scholar
Benjamin, H. The transsexual phenomenon. New York: The Julian Press; 1966.Google Scholar
Benjamin, H. Transvestism and transsexualism in the male and female. J Sex Res 1967;3:107–27.Google Scholar
Bentler, PM. A typology of transsexualism: gender identity theory and data. Arch Sex Behav 1976;5:567–84.CrossRefGoogle ScholarPubMed
Blanchard, R. Typology of male-to-female transsexualism. Arch Sex Behav 1985;14:247–61.CrossRefGoogle ScholarPubMed
Blanchard, R. Nonhomosexual gender dysphoria. J Sex Res 1988;24:188–93.CrossRefGoogle ScholarPubMed
Blanchard, RSteiner, BW. Gender reorientation, psychological adjustment, and involvement with female partners in female-to-male transsexuals. Arch Sex Behav 1983;12:149–57.CrossRefGoogle Scholar
Blanchard, RSteiner, BWClemmensen, LH. Gender dysphoria, gender reorientation, and the clinical management of transsexualism. J Consult Clin Psychol 1985;53:295–304.CrossRefGoogle ScholarPubMed
Blanchard, RLegault, SLindsay, WR. Vaginoplasty outcome in male-to-female transsexuals. J Sex Marital Ther 1987;13:265–75.CrossRefGoogle ScholarPubMed
Blanchard, RSteiner, BWClemmensen, LHDickey, R. Prediction of regrets in postoperative transsexuals. Can J Psychiatr 1989;34:43–5.CrossRefGoogle ScholarPubMed
Bodlund, OKullgren, G. Transsexualism – general outcome and prognostic factors: a five-year follow-up study of nineteen transsexuals in the process of changing sex. Arch Sex Behav 1996;25:303–16.Google ScholarPubMed
Calanca, A. Le transsexual après le changement. Evolution et pronostic. Helvetica chirurgica Acta 1991;58:257–60.Google Scholar
Caron, GArcher, R. MMPI Rorschach characteristics of individuals approved for gender reassignment surgery. Assessment 1997;4:229–41.CrossRefGoogle ScholarPubMed
Chiland, C. Changer de sexe. Paris: itions Odile Jacob; 1997.Google Scholar
Cohen, Lde Ruiter, CRingelberg, HCohen-Kettenis, PT. Psychological functioning of adolescent transsexuals: personality and psychopathology. J Clin Psychol 1997;53:187–96.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
Cohen-Kettenis, PTWalinder, J. Sex reassignment surgery in Europe: a survey. Acta Psychiatr Scand 1987;75:176–82.Google ScholarPubMed
Cohen-Kettenis, PTvan Goozen, S. Sex reassignment of adolescents transsexuals: a follow-up study. J Am Acad Child Adolesc Psychiatr 1997;36:263–71.CrossRefGoogle ScholarPubMed
Cohen, LCohen-Kettenis, PT. Psychological changes after sexual reassignment surgery in adolescent transsexuals. Paper presented at the XVI International Congress of Rorschach and Projective Methods, Amsterdam. 1999.Google Scholar
Dixen, JMMaddever, Hvan Maasdam, JEdwards, PW. Psychosocial characteristics of applicants evaluated for surgical cross-gender reassignment. Arch Sex Behav 1984;13:269–76.CrossRefGoogle Scholar
Doorn, CD. Towards a gender identity theory of transsexualism. Unpublished Doctoral thesis. Amsterdam: Vrije Universiteit te Amsterdam; 1997.Google Scholar
Edgerton, MTMeyer, JK. Surgical and psychiatric aspects of transsexualism. In: Horton, C editor. Surgery of the external genitalia. Boston: Little Brown; 1973. p. 117–61.Google Scholar
Eldh, JBerg, AGustafsson, M. Long term follow-up after sex reassignment surgery. Scand J Plast Reconstr Hand Surg 1997;31:39–45.Google ScholarPubMed
Fahrner, EMKockott, GDuran, G. Die psychosociale integration operierter transsexuallen. Nervenarzt 1987;58:340–8.Google Scholar
Finney, JBrandsma, JTondow, Mle Maestre, G. A study of transsexuals seeking gender reassignment. Am J Psychiatr 1975;132:62–964.Google ScholarPubMed
Fleming, MCohen, DSalt, PJones, DJenkins, S. A study of pre- and postsurgical transsexuals: MMPI characteristics. Arch Sex Behav 1981;10:161–70.CrossRefGoogle ScholarPubMed
Fleming, MJones, DSimons, J. Preliminary results of pre and postoperative transsexuals. J Clin Psychol 1982;38:408–15.3.0.CO;2-8>CrossRefGoogle Scholar
Fisk, N. Five spectacular results. Arch Sex Behav 1978;7:351–69.CrossRefGoogle ScholarPubMed
Greenberg, RPLaurence, L. A comparison of the MMP results for psychiatric patients and male applicants for transsexuals surgery. J Nerv et Ment Dis 1981;169:320–3.CrossRefGoogle Scholar
Green, RFleming, D. Transsexual surgery follow-up status in the 1990s. Annu Rev Sex Res 1990;1:163–74.Google Scholar
Gutheil, E. The psychologic background of Transsexualism and Transvestism. Am J Psychother 1954;8:231–9.Google ScholarPubMed
Hamburger, C. Endocrine treatment of male and female transsexualism. In: Green, RMoney, J editors. Transsexualism and sex reassignment. Baltimore: John Hopkins University Press; 1969.Google Scholar
Harry Benjamin International Gender Dysphoria Association. Standards of care: the hormonal and surgical sex reassignment of gender dysphoric persons. Arch Sex Behav 1985;14:79–90.CrossRefGoogle Scholar
Hastings, M. Postsurgical adjustment of male transsexual patients. Clin Plast Surg 1974;1:335–44.Google ScholarPubMed
Hastings, MMarkland, C. Post-surgical adjustment of twenty-five transsexuals (male-to-female) in the university of Minnesota study. Arch Sex Behav 1978;7:327–36.CrossRefGoogle ScholarPubMed
Hergott, S. Glissements progressifs du DSM. J Fr Psychiatrie 1997;5:40–2.Google Scholar
Hertz, JTillinger, KGWestman, A. Transvestism. Acta Psychiatr Scand 1961;37:283–94.CrossRefGoogle Scholar
Hill, E. A comparison of three psychological testings of a transsexual. J Pers Assess 1980;44:52–100.CrossRefGoogle ScholarPubMed
Hoenig, JKenna, JCYoud, A. Surgical treatment for transsexualism. Acta Psychiatr Scand 1971;47:106–33.CrossRefGoogle ScholarPubMed
Hore, BDNicolle, FVCalnan, JS. Male transsexualism in England: sixteen cases with surgical intervention. Arch Sex Behav 1975;4:81–8.CrossRefGoogle ScholarPubMed
Hunt, DDHampson, JL. Follow-up of 17 biologic male transsexual after sex-reassignment surgery. Am J Psychiatr 1980;137:432–8.Google Scholar
Jayaram, BNStuteville, OHBush, IM. Complications and undesirable results of sex-reassignment surgery in male-to-female transsexuals. Arch Sex Behav 1978;7:337–45.CrossRefGoogle ScholarPubMed
Johnson, SHunt, DD. The relationship of male transsexual typology to psychosocial adjustment. Arch Sex Behav 1990;19:349–60.CrossRefGoogle ScholarPubMed
Kockott, GFahrner, EM. Transsexuals who have not undergone surgery: a follow-up study. Arch Sex Behav 1987;16:511–22.Google Scholar
Kockott, GFahrner, EM. Male-to-female and female-to-male transsexuals: a comparison. Arch Sex Behav 1988;6:539–46.CrossRefGoogle Scholar
Krohn, WBertermann, HWand, HWille, R. Nachtuntersuchung bei opeierten transsexuallen. Transsexualism – a long term follow-up after sex reassignment surgery. Nevenarzt 1981;52:26–31.Google Scholar
Kuiper, AJ. Transseksualiteit. Evaluatie van de geslachtsaanpassende behanding. Unpublished Doctoral thesis. Amsterdam: Vrije Universiteit te Amsterdam; 1991.Google Scholar
Kuiper, AJCohen-Kettenis, PT. Sex reassignment surgery: a study of 141 Dutch transsexuals. Arch Sex Behav 1988;17:439–57.CrossRefGoogle ScholarPubMed
Langevin, RPaitich, DSteiner, B. The clinical profile of male transsexuals living as females versus those living as males. Arch Sex Behav 1977;6:143–54.CrossRefGoogle Scholar
Laub, DRFisk, NM. A rehabilitation program for gender dysphoria syndrome by surgical sex change. Plast Reconstr Surg 1974;4:388–403.CrossRefGoogle Scholar
Levine, SBLothstein, L. Transsexualism or the gender dysphoria syndromes. J Sex Marital Ther 1981;7:85–113.CrossRefGoogle ScholarPubMed
Lief, HHubschman, L. Orgasm in postoperative transsexual. Arch Sex Behav 1993;22:145–55.CrossRefGoogle ScholarPubMed
Lindemalm, GKorlin, DUddenberg, N. Long term follow-up of sex change in 13 male-to-female transsexuals. Arch Sex Behav 1986;15:187–210.CrossRefGoogle ScholarPubMed
Lindemalm, GKorlin, DUddenberg, N. Pronostic factors vs. outcome in male-to-female transsexualism. A follow-up study of 13 cases. Acta Psychiatr Scand 1987;75:268–74.CrossRefGoogle Scholar
Lindgren, TPauly, I. A body image scale for evaluating transsexuals. Arch Sex Behav 1975;4:639–56.CrossRefGoogle ScholarPubMed
Lothstein, LM. The aging gender dysphoria (transsexual) patient. Arch Sex Behav 1979;8:431–44.CrossRefGoogle ScholarPubMed
Lothstein, LM. The postsurgical transsexual: empirical and theoretical considerations. Arch Sex Behav 1980;9:547–64.CrossRefGoogle ScholarPubMed
Lothstein, LM. Sex reassignment surgery: historical, bioethical and theoretical issues. Am J Psychiatr 1982;139:417–26.Google ScholarPubMed
Lothstein, LM. Psychological-testing with transsexuals – a 30 year review. J Pers Assess 1984;48:500–7.CrossRefGoogle ScholarPubMed
Lukianowicz, N. Survey of various aspects of transvestism in the light of our present knowledge. J Nerv Ment Dis 1959;128:36–64.CrossRefGoogle ScholarPubMed
Lundström, B. Gender dysphoria – a social-psychiatric follow-up study of 31 cases not accepted for sex reassignment. Göteborg: University of Göteborg; 1981.Google Scholar
Lundström, BPauly, IWalinder, J. Outcome of sex reassignment surgery. Acta Psychiatr Scand 1984;70:289–94.CrossRefGoogle ScholarPubMed
Mate-Kole, CFreschi, MRobin, A. Aspects of psychiatric symptoms at different stages in the treatment of transsexualism. Br J Psychiatr 1988;152:550–3.CrossRefGoogle ScholarPubMed
Mate-Kole, CFreschi, MRobin, A. A controlled study of psychological and social change after surgical gender reassignment in selected male transsexuals. Br J Psychiatr 1990;157:261–4.Google ScholarPubMed
Mate-Kole, CRobin, AFreschi, M. Benefits of surgical reassignment as perceived by operated male transsexual patients. Gender Dysphoria 1990;1:73–7.Google Scholar
Mc Cauley, EEhrhardt, A. Follow-up of females with gender identity disorders. J Nerv Ment Dis 1984;172:353–8.CrossRefGoogle Scholar
McEvan, LCeber, SDaws, J. Male-to-female surgical genital reassignment. In: Walters, WARoss, MW editors. Transsexualism and sex reassignment. Melbourne: Oxford University Press; 1986.Google Scholar
Merloo, J. Change of sex and collaboration with the psychosis. Am J Psychiatr 1967;2:263–4.CrossRefGoogle Scholar
Meyer, JK. Psychiatric considerations in the sexual reassignment of non intersex individuals. Clin Plast Surg 1974;1:275–83.CrossRefGoogle ScholarPubMed
Meyer, JKReter, DJ. Sex reassignment: follow-up. Arch Gen Psychiatr 1979;36:1010–5.CrossRefGoogle ScholarPubMed
Michel, A. Le changement de sexe: une métamorphose sans conséquence?Thèse de doctorat. Liège: Université de Liège; 2000.Google Scholar
Money, J. Prefactory remarks on outcome of sex reassignment in 24 cases of transsexualism. Arch Sex Behav 1971;1:163–5.Google Scholar
Money, JBrennan, JG. Sexual dismorphism in the psychology of female transsexuals. J Nerv Ment Dis 1968;147:487–99.CrossRefGoogle Scholar
Money, JPrimrose, C. Sexual dismorphism and dissociation in the psychology of male transsexuals. J Nerv Ment Dis 1968;5:472–86.CrossRefGoogle Scholar
Money, JEhrhardt, AA. Transsexualle nach Gelechtswechsel. In: Schmidt, G e.a., editor. Tendenzen der Sexualforschung. Stuttgart: Enke; 1970. p. 70–87.Google Scholar
Mormont, CMichel, AWauthy, J. Transsexualism and connection with reality: Rorschach data. Rorschachiana: yearbook of the international Rorschach society, vol. 20. 1995. p. 172–87.Google Scholar
Murray, J. Borderline manifestations in the Rorschachs of male transsexuals. J Pers Assess 1985;49:454–66.CrossRefGoogle ScholarPubMed
Ostow, M. Letter to the editor. J Am Med Association 1953;152:1552–3.Google Scholar
Paris, H. Généalogie du transsexualism. L’évolution psychiatrique 1991;56:785–803.Google Scholar
Pauly, IB. Male psychosexual inversion: transsexualism. A review of 100 cases. Arch Gen Psychiatr 1965;13:172–81.CrossRefGoogle ScholarPubMed
Pauly, IB. The current status of the change of sex operation. J Nerv Ment Dis 1968;147:460–71.CrossRefGoogle ScholarPubMed
Pauly, IB. Female transsexualism: part I. Arch Sex Behav 1974;3:487–507.CrossRefGoogle ScholarPubMed
Pauly, IB. Outcome of sex-reassignment surgery for transsexuals.. Aust N Z J Psychiatr 1981;15:45–51.CrossRefGoogle ScholarPubMed
Person, EOvesey, L. The transsexual syndromes in males: I. Primary transsexualism. Am J Psychother 1974;26:4–20.CrossRefGoogle Scholar
Pfäfflin, F. Regrets after sex reassignment surgery. In: Bockting, WOColeman, E editors. Gender dysphoria, interdisciplinary approaches in clinical management. Binghamton, NY: The Haworth Press; 1992.Google Scholar
Pfäfflin, FJunge, A. Nachuntersuchungen nach geschlechusumwandlung: eine kemmentierte literatureubersicht 1961–1991〚Follow-up studies after sex reassignment surgery: a review 1961–1991〛. Stuttgart: Scahttauer; 1992. p. 149–459.Google Scholar
Pomeroy, WB. Transsexualism and sexuality: sexual behavior of pre and postoperative male transsexuals. In: Green, RMoney, J editors. Transsexualism and sex reassignment. Baltimore: John Hopkins Press; 1969.Google Scholar
Rakic, ZStarcevic, VMaric, JKelin, K. The outcome of sex reassignment surgery in Belgrade: 32 patients of both sexes. Arch Sex Behav 1996;25:515–25.Google ScholarPubMed
Randell, JPreoperative and postoperative status of male and female transsexual. In: Green, RMoney, J editors. Transsexualism and sex reassignment. Baltimore: John Hopkins; 1969.Google Scholar
Randell, J. Indications for sex reassignment surgery. Arch Sex Behav 1971;1:153–61.Google ScholarPubMed
Rauchfleisch, DBarth, DBattegay, R. Resuktate einer Langzeitkatamnese von Transsexuallen. Der Nervenarzt 1998;9:799–805.CrossRefGoogle Scholar
Rehman, JLazer, SBenet, ASchaefer, LMelman, A. The reported sex and surgery satisfactions of 28 postoperative male-to-female transsexual patients. Arch Sex Behav 1999;28:71–89.CrossRefGoogle ScholarPubMed
Reid, RW. Aspects psychiatriques et psychologiques du transsexualism. Actes du XXIIIe Colloque de droit européen. Vrije Universiteit Amsterdam; 1993.Google Scholar
Roback, HBMcKee, EWebb, WAbramowitz, CAbramowitz, S. Psychopathology in female sex change applicants and two help-seeking controls. J Abnorm Psychol 1976;85:430–2.CrossRefGoogle ScholarPubMed
Rosen, A. Brief report of MMPI characteristics of sexual deviation. Psychol Rep 1974;35:73–4.CrossRefGoogle ScholarPubMed
Ross, MWNeed, JA. Effects of adequacy of gender reassignment surgery on psychology and adjustments: a follow-up of fourteen male-to-female patients. Arch Sex Behav 1989;18:145–53.CrossRefGoogle ScholarPubMed
Sadoughi, WJayaram, BBush, I. Post-operative changes in the self concept of transsexuals as measured by the Tennessee self-concept scale. Arch Sex Behav 1978;7:347–9.CrossRefGoogle Scholar
Snaith, PTarsh, MJReid, R. Sex reassignment surgery. A study of 141 Dutch transsexuals. Br J Psychiatr 1993;162:681–5.CrossRefGoogle ScholarPubMed
Stinson, B. A study of twelve applicants for transsexual surgery. Ohio State Med J 1972;68:245–9.Google ScholarPubMed
Socarides, C. The desire for sexual transformation: a psychiatric evaluation of transsexualism. Am J Psychiatr 1969;10:1419–26.CrossRefGoogle Scholar
Sorensen, T. A follow-up study of operated transssexual females. Acta Psychiatr Scand 1981;64:50–64.CrossRefGoogle ScholarPubMed
Sorensen, T. A follow-up study of operated transssexual males. Acta Psychiatr Scand 1981;63:486–503.CrossRefGoogle ScholarPubMed
Spengler, A. Kompromisse statt Stigma und Unsicherheit. Sexualmedizin 1980;3:98–103.Google Scholar
Stein, MTiefer, LMelman, A. Follow-up observations of operated male-to-female transsexuals. J Urol 1990;143:1188–92.CrossRefGoogle ScholarPubMed
Stoller, R. Presentations of gender. New Haven and LondonYale University Press; 1985 Masculin ou féminin ? Traduc. Franç. Par Y. Noizet et C. Chiland, Paris, Puf, 1989.Google Scholar
Stone, C. Psychiatric screening for transsexual surgery. Psychosomatics 1977;18:25–7.CrossRefGoogle ScholarPubMed
Stürup, G. Male transsexuals. A long-term follow-up after sex reassignment operations. Acta Psychiatr Scand 1976;53:51–63.Google ScholarPubMed
Tsushima, WTWedding, D. MMPI results of male candidates for transsexual surgery. J Person Deviation 1979;43:385–7.Google ScholarPubMed
Verschoor, APoortinga, J. Psychosocial differences between Dutch male and female transsexuals. Arch Sex Behav 1988;17:173–9.CrossRefGoogle ScholarPubMed
Vogt, JH. Five cases of transsexualism in females. Acta Psychiatr Scand 1968;44:62–88.CrossRefGoogle ScholarPubMed
Walinder, J. Transsexualism, a study of forty-three cases vol. 1. Göteburg: Scandinavian University Books; 1967.Google Scholar
Walinder, JThuwe, I. A social-psychiatric follow-up study of 24 sex-reassigned transsexuals. Reports from the Psychiatric Research Center, St Jorgen's Hospital, University of Göteborg, Sweden 10. Akademiforlager, 1975.Google Scholar
Walinder, JLundström, BThuwe, I. Prognostic factors in the assessment of male transsexuals for sex reassignment. Br J Psychiatr 1978;132:16–20.CrossRefGoogle Scholar
Walters, WAWRoss, MW. Transsexualism and sex reassignment. Oxford: Oxford University Press; 1986.Google Scholar
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