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Journal articles on the topic 'Sexual Reassignment Surgery (SRS)'

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Published: 4 June 2021
Last updated: 18 February 2022

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1

Wierckx, Katrien, Els Elaut, Eva Van Caenegem, et al. "Sexual desire in female-to-male transsexual persons: exploration of the role of testosterone administration." European Journal of Endocrinology 165, no. 2 (2011): 331–37. http://dx.doi.org/10.1530/eje-11-0250.

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ObjectiveTo describe sexual desire in female-to-male transsexual persons post sex reassignment surgery (SRS). The associations between serum androgen levels and sexual desire are examined.DesignSingle center cross-sectional study.MethodsForty-five female-to-male transsexual persons post SRS completed a standardized questionnaire assessing sexual desire (Sexual Desire Inventory). In addition, participants were asked questions on sexual desire before starting hormone treatment and having SRS. Serum levels of testosterone, LH and sex hormone-binding globulin were measured on fasting morning serum samples.ResultsIn retrospect, 73.9% of the participants reported an increase in sexual desire after hormone treatment and SRS. Solitary sexual desire scores were significantly correlated with frequency of masturbation (r=0.835;P<0.001), whereas frequency of sexual intercourse with a partner was not. No direct associations were found between testosterone and solitary or dyadic sexual desire. However, ANOVA showed an independent effect of LH on solitary sexual desire (P<0.001).Post hocanalysis revealed that female-to-male transsexual persons with elevated levels of LH, indicating suboptimal testosterone therapy, reported significantly lower solitary sexual desire levels (than those with low LH levels;P=0.007). Suppressed LH levels were also associated with having a higher need for sexual activities (P=0.009) and a higher frequency of excessive sexual desire (P=0.007).ConclusionMost female-to-male transsexual persons report on a marked increase in sexual desire after testosterone treatment and SRS. No direct associations between levels of testosterone and solitary or dyadic sexual desire were found. However, measures of sexual desire were inversely associated with LH levels.
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2

Jokić-Begić, Nataša, Anita Lauri Korajlija, and Tanja Jurin. "Psychosocial Adjustment to Sex Reassignment Surgery: A Qualitative Examination and Personal Experiences of Six Transsexual Persons in Croatia." Scientific World Journal 2014 (2014): 1–12. http://dx.doi.org/10.1155/2014/960745.

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In Croatia, transgender individuals face numerous social and medical obstacles throughout the process of transition. The aim of this study was to depict the factors contributing to the psychosocial adjustment of six transsexual individuals living in Croatia following sex reassignment surgery (SRS). A combination of quantitative and qualitative self-report methods was used. Due to the specificity of the sample, the data were collected online. Standardized questionnaires were used to assess mental health and quality of life alongside a series of open-ended questions divided into 4 themes: the decision-making process regarding SRS; social and medical support during the SRS process; experience of discrimination and stigmatizing behaviors; psychosocial adjustment after SRS. Despite the unfavorable circumstances in Croatian society, participants demonstrated stable mental, social, and professional functioning, as well as a relative resilience to minority stress. Results also reveal the role of pretransition factors such as high socioeconomic status, good premorbid functioning, and high motivation for SRS in successful psychosocial adjustment. During and after transition, participants reported experiencing good social support and satisfaction with the surgical treatment and outcomes. Any difficulties reported by participants are related to either sexual relationships or internalized transphobia. The results also demonstrate the potentially protective role that a lengthier process of transition plays in countries such as Croatia.
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Imbimbo, C., P. Verze, D. Arcaniolo, and V. Mirone. "Male to Female Transsexualism." Urologia Journal 74, no. 4 (2007): 187–96. http://dx.doi.org/10.1177/039156030707400401.

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The transsexual is a person who suffers from a deep identity disturbance caused by physical characteristics which do not correspond to mental traits and tendencies. The persistent sense of contradiction between his or her deceptive sexual appearance and his or her inner perception, causes a strong desire to achieve harmonization of the two. This aspiration, even if modification of chromosomal sex is impossible, can be fulfilled by undergoing SRS (Sex Reassignment Surgery). SRS represents the last major step of a clinical, therapeutic and diagnostic program involving skilled professionals in the physical and psychological sciences. Their assistance and counseling helps the patient to calmly and consciously decide to undergo SRS. A surgeon has the obligation not only to validate the operation outcome, but to also to maintain a long-term follow-up. A transsexual is not just like any other person; he or she should therefore be treated with sympathy and understanding. The surgeon should try his best to establish a relationship of mutual trust, taking into account the causes of anxiety and stress felt by the patient, and keeping in mind the ultimate objective, which is an improvement in the quality of life. At present, the most widely used surgical techniques are the Simple Penile Skin Inversion, the Penile-scrotal flap Inversion and the enterovaginoplasty. Each surgical technique has its own advantages and disadvantages, and it is up to the surgeon, in discussion with the patient, to make the appropriate choice. The surgical technique performing the Simple Penile Skin Inversion seems to ensure a better cosmetic appearance and an adequate lubrication, but a lower rate of satisfaction, in relation to the neocavity depth. On the contrary, the Penile-Scrotal Flap Inversion guarantees an adequate vaginal depth and lubrication, even though the cosmetic appearance is not always completely satisfactory. In our experience, a significant number of patients were satisfied with the chosen surgery and felt comfortable with their new post-operative gender. Taking into account all the complications involved, none of the patients did regret; actually, they would recommend the same operation to others. The overall results of some studies carried out on patient satisfaction before and after SRS show a marked post-surgery improvement of sexual life.
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4

Pigot, G., M. B. Bouman, S. Horvat, et al. "HP-04-005 Sex reassignment surgery (SRS) without urethral lengthening in female to male (FtM) transgenders. Functional outcomes, patient satisfaction and sexual function." Journal of Sexual Medicine 13, no. 5 (2016): S127. http://dx.doi.org/10.1016/j.jsxm.2016.03.125.

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5

Andrade, R. T., K. S. Rodrigues, A. Machado, and V. M. Silva. "PNM-01 Sexual Reassignment Surgery - Sexual Satisfaction." Journal of Sexual Medicine 14, no. 12 (2017): e383. http://dx.doi.org/10.1016/j.jsxm.2017.10.049.

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6

Schneider, Maiko A., Tahiana Andreazza, Anna Martha V. Fontanari, et al. "Serum concentrations of brain-derived neurotrophic factor in patients diagnosed with gender dysphoria undergoing sex reassignment surgery." Trends in Psychiatry and Psychotherapy 39, no. 1 (2017): 43–47. http://dx.doi.org/10.1590/2237-6089-2016-0033.

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Abstract Introduction: Transsexualism (ICD-10) is a condition characterized by a strong and persistent dissociation with one's assigned gender. Sex reassignment surgery (SRS) and hormone therapy provide a means of allowing transsexual individuals to feel more congruent with their gender and have played a major role in treatment over the past 70 years. Brain-derived neurotrophic factor (BDNF) appears to play a key role in recovery from acute surgical trauma and environmentally mediated vulnerability to psychopathology. We hypothesize that BDNF may be a biomarker of alleviation of gender incongruence suffering. Objectives: To measure preoperative and postoperative serum BDNF levels in transsexual individuals as a biomarker of alleviation of stress related to gender incongruence after SRS. Methods: Thirty-two male-to-female transsexual people who underwent both surgery and hormonal treatment were selected from our initial sample. BDNF serum levels were assessed before and after SRS with sandwich enzyme linked immunosorbent assay (ELISA). The time elapsed between the pre-SRS and post-SRS blood collections was also measured. Results: No significant difference was found in pre-SRS or post-SRS BDNF levels or with relation to the time elapsed after SRS when BDNF levels were measured. Conclusion: Alleviation of the suffering related to gender incongruence after SRS cannot be assessed by BDNF alone. Surgical solutions may not provide a quick fix for psychological distress associated with transsexualism and SRS may serve as one step toward, rather than as the conclusion of, construction of a person's gender identity.
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7

Hoebeke, P., G. Tsjoen, S. Monstrey, G. Selvaggi, R. Beerten, and G. De Cuypere. "337 Sexual functioning after sex reassignment surgery." European Urology Supplements 3, no. 2 (2004): 87. http://dx.doi.org/10.1016/s1569-9056(04)90336-3.

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Andrade, R. T., J. C. Silva, and V. M. Silva. "PNM-03 Sexual Reassignment Surgery - Initial Experience." Journal of Sexual Medicine 14, no. 12 (2017): e384. http://dx.doi.org/10.1016/j.jsxm.2017.10.051.

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De Cuypere, Griet, Guy TSjoen, Ruth Beerten, et al. "Sexual and Physical Health After Sex Reassignment Surgery." Archives of Sexual Behavior 34, no. 6 (2005): 679–90. http://dx.doi.org/10.1007/s10508-005-7926-5.

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10

Macdonald-Labelle, Stefan. "A Critique of Gender Identity Disorder and its Application." Revue interdisciplinaire des sciences de la santé - Interdisciplinary Journal of Health Sciences 2, no. 2 (2012): 41. http://dx.doi.org/10.18192/riss-ijhs.v2i2.1520.

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For some, Gender Identity Disorder (GID) becomes the only way to achieve sex reassignment surgery (SRS). It will be shown that GID acts as a problematic regulatory mechanism based on its application. It will be argued that GID normalizes a dichotomous view of gender. In this way, GID’s implicit applications allow the mental health professional to assert their views of what proper gendered behavior is, further normalizing a binary view of gender. Insurance companies require a GID diagnosis in order to provide economic assistance to those wishing to undergo sex reassignment surgery. Those who cannot afford to transition must fall under GID’s gaze in order to achieve SRS. This will be shown to be unacceptable and a way in which GID operates as a regulatory mechanism. Appealing to a GID diagnosis can further stigmatize the individual who wishes to transition due to the necessitation of distress as an explicit mechanism of diagnosis. Having to fall under GID may internalize the negative aspects of the diagnosis. A criticism of GID as a form of psychopathology will be given and also be linked to the idea of GID as a regulatory apparatus. It will be shown that there should be no link between ethical discomfort and GID-free sex reassignment surgery. Also, it will be shown that psychopathology has normalizing capabilities that further entrench gender binaries. It is important to consider the removal of GID from the DSM, but, as a condition, still offer funding for sex reassignment surgery without having to appeal to a mental health professional’s assessment.
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11

Prunas, Antonio, Elisa Bandini, Alessandra D. Fisher, et al. "Experiences of Discrimination, Harassment, and Violence in a Sample of Italian Transsexuals Who Have Undergone Sex-Reassignment Surgery." Journal of Interpersonal Violence 33, no. 14 (2016): 2225–40. http://dx.doi.org/10.1177/0886260515624233.

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The present study aims to provide an overview of experiences of discrimination, harassment, and violence in a sample of Italian transsexuals who have undergone sex-reassignment surgery (SRS). Lack of support for gender transition from family members was also assessed, before and after SRS. Data were collected in the context of a multicentric study (Milan, Florence, and Bari) on SRS outcome. Patients who underwent SRS were contacted and asked to fill out a questionnaire concerning experiences of discrimination, harassment, violence, and crime they might have experienced in previous years. Seventy-two participants took part in the research: 46 were male-to-female (MtF; 64%) and 26 were female-to-male (FtM; 36%). Thirty-six percent of the total sample (with no differences between MtF and FtM) experienced at least one episode of harassment, violence, or discrimination. The workplace was reported to be the social area with the highest risk of discrimination and harassment (22% of participants). Reports of more than one incident of discrimination, harassment, and violence characterized the majority of participants in the MtF sample. Compared with previous studies carried out in other countries, a much larger proportion of participants could count on a supportive family environment before and after transition. Our results show that Italian society at large is prejudiced against transsexuals, but at a more “micro” level, having a trans person as a family member might result in a protective and tolerant attitude.
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12

Fitzgibbons, Richard P. "Transsexual Attractions and Sexual Reassignment Surgery: Risks and Potential Risks." Linacre Quarterly 82, no. 4 (2015): 337–50. http://dx.doi.org/10.1080/00243639.2015.1125574.

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Fitzgibbons, Richard P. "Transsexual Attractions and Sexual Reassignment Surgery: Risks and Potential Risks." Linacre Quarterly 83, no. 2 (2016): 337–50. http://dx.doi.org/10.1080/00243639.2015.1125574a.

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14

Krick, Marisa. "Pain With Vaginal Dilation in a Patient Following Sexual Reassignment Surgery." Journal of Womenʼs Health Physical Therapy 39, no. 1 (2015): 10–16. http://dx.doi.org/10.1097/jwh.0000000000000022.

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15

Schneider, Florian, Nina Neuhaus, Joachim Wistuba, et al. "Testicular Functions and Clinical Characterization of Patients with Gender Dysphoria (GD) Undergoing Sex Reassignment Surgery (SRS)." Journal of Sexual Medicine 12, no. 11 (2015): 2190–200. http://dx.doi.org/10.1111/jsm.13022.

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16

Vukadinovic, Vojkan, Borko Stojanovic, Marko Majstorovic, and Aleksandar Milosevic. "The Role of Clitoral Anatomy in Female to Male Sex Reassignment Surgery." Scientific World Journal 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/437378.

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Introduction. Controversies on clitoral anatomy and its role in female sexual function still make clitoral reconstructive surgery very challenging. We evaluated the role of clitoral anatomic features in female to male sex reassignment surgery.Material and Methods. The study included 97 female transsexuals, aged from 18 to 41 years, who underwent single stage metoidioplasty between March 2008 and January 2013. The operative technique involved vaginectomy, the release of clitoral ligaments and urethral plate, urethroplasty by combining buccal mucosa graft and genital flaps, and scrotoplasty with insertion of testicle prostheses. Postoperative questionnaire was used to evaluate aesthetic, functional, and sexual outcome.Results. The mean followup was 30 months. The mean length of the neophallus was 7 cm, compared to mean preoperative length of the hypertrophied clitoris of 3.3 cm. Complications occurred in 27.84% of all patients, related mostly to urethroplasty. Voiding while standing was achieved in all cases. None of the patients had problems in sexual arousal, masturbation, or orgasms.Conclusion. Accurate knowledge of the clitoral anatomy, physiology, and neurovascular supply is crucial for a successful outcome of female to male sex reassignment surgery. Our approach appears to ensure overall satisfaction and high quality of sexual life.
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17

Furton, Edward J. "Catholic Teaching on Sex-Reassignment." Ethics & Medics 41, no. 6 (2016): 3–4. http://dx.doi.org/10.5840/em201641612.

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Carol Bayley’s double-effect reasoning in defense of sex-reassignment surgery fails at the opening. The first condition of the principle is that the act in itself must be morally good or at least neutral. She says, without argument, “the surgery itself is neutral.” How so? The surgery is a direct assault on the physical integrity of a person whose sexual organs are perfectly healthy. Is it reasonable to say that a person who wants to change gender has a body that is in fact seriously deformed or diseased? Where is the evidence? If reality is defined by the mind, then the imagination may freely think of personal identity in any conceivable way. Nature is set aside and in its place is put, at best, a delusion and, at worst, an ideology that seeks to do violence to nature. Catholic hospitals should not participate in this assault upon God’s creation.
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Mazaheri Meybodi, Azadeh, Ahmad Hajebi, and Atefeh Ghanbari Jolfaei. "Psychiatric Axis I Comorbidities among Patients with Gender Dysphoria." Psychiatry Journal 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/971814.

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Objectives. Cooccurring psychiatric disorders influence the outcome and prognosis of gender dysphoria. The aim of this study is to assess psychiatric comorbidities in a group of patients.Methods. Eighty-three patients requesting sex reassignment surgery (SRS) were recruited and assessed through the Persian Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I).Results. Fifty-seven (62.7%) patients had at least one psychiatric comorbidity. Major depressive disorder (33.7%), specific phobia (20.5%), and adjustment disorder (15.7%) were the three most prevalent disorders.Conclusion. Consistent with most earlier researches, the majority of patients with gender dysphoria had psychiatric Axis I comorbidity.
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Wolter, A., J. Diedrichson, T. Scholz, A. Arens-Landwehr, and J. Liebau. "Sexual reassignment surgery in female-to-male transsexuals: An algorithm for subcutaneous mastectomy." Journal of Plastic, Reconstructive & Aesthetic Surgery 68, no. 2 (2015): 184–91. http://dx.doi.org/10.1016/j.bjps.2014.10.016.

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Pumsup, Juthapot. "How to ensure clitoral bud survival in a sexual reassignment surgery for transsexualism." Journal of Cosmetic Medicine 2, no. 1 (2018): 57–62. http://dx.doi.org/10.25056/jcm.2018.2.1.57.

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Bartolucci, Constanza, Esther Gómez‐Gil, Manel Salamero, et al. "Sexual Quality of Life in Gender‐Dysphoric Adults before Genital Sex Reassignment Surgery." Journal of Sexual Medicine 12, no. 1 (2015): 180–88. http://dx.doi.org/10.1111/jsm.12758.

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22

Wierckx, Katrien, Eva Van Caenegem, Els Elaut, et al. "Quality of Life and Sexual Health after Sex Reassignment Surgery in Transsexual Men." Journal of Sexual Medicine 8, no. 12 (2011): 3379–88. http://dx.doi.org/10.1111/j.1743-6109.2011.02348.x.

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Jindarak, Sirachai, Kasama Nilprapha, Taywin Atikankul, et al. "Spermatogenesis Abnormalities following Hormonal Therapy in Transwomen." BioMed Research International 2018 (2018): 1–5. http://dx.doi.org/10.1155/2018/7919481.

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Objective. To measure spermatogenesis abnormalities in transwomen at the time of sex reassignment surgery (SRS) and to analyze the association between hormonal therapy duration and infertility severity.Design. Retrospective study.Setting. University hospital.Patients. One-hundred seventy-three transwomen who underwent SRS from January 2000 to December 2015.Interventions. All orchidectomy specimens were retrospectively reviewed and classified. History of hormonal therapy duration was retrieved from medical records.Main Outcome Measures. Histological examinations of orchidectomy specimens were performed to assess spermatogenesis.Results. One-hundred seventy-three orchidectomy specimens were evaluated. Histological examinations showed maturation arrest in 36.4%, hypospermatogenesis in 26%, Sertoli cell-only syndrome in 20.2%, normal spermatogenesis in 11%, and seminiferous tubule hyalinization in 6.4% of the specimens. Spermatogenesis abnormality severity was not associated with the total therapy duration (P=0.81) or patient age at the time of surgery (P=0.88). Testicular volumes and sizes were associated with spermatogenesis abnormality severity (P=0.001andP=0.026, right testicle and left testicle, resp.).Conclusion(s). Feminizing hormonal treatment leads to reductions in testicular germ cell levels. All transwomen should be warned about this consequence, and gamete preservation should be offered before starting hormonal treatment.
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Stephens, Travis. "The Principle of Totality Does Not Justify Sex Reassignment Surgery." Ethics & Medics 41, no. 11 (2016): 1–2. http://dx.doi.org/10.5840/em2016411121.

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Expert opinions diverge on appropriate treatment for gender dysphoria. Some encourage the pursuit of counseling that helps one to identify with one’s natal sex. Others encourage people struggling with gender dysphoria to change the body to match the so-called inside. The latter advocate the use of hormone replacement therapies and sex reassignment surgeries to facilitate the transition. Such procedures are not only immoral because they render the patient sterile, but also because they reject the God-given personhood that is manifest through one’s sexuality. Since sexuality constitutes so much more than genitalia, sex reassignment surgery does not actually change one’s sexuality. Rather, it merely maims the individual, limiting her ability to love authentically as a sexual person. Out of respect for the human person, the only appropriate course of action is to counsel these individuals and encourage them to overcome the inhibitions that prevent them from embracing their natal sex.
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Schneider, F. J., N. Kossack, J. Wistuba, S. Schlatt, and S. Kliesch. "In-depth characterization of human testicular tissue from patients suffering from gender identity disorder (GID) undergoing sex-reassignment surgery (SRS)." Fertility and Sterility 100, no. 3 (2013): S67—S68. http://dx.doi.org/10.1016/j.fertnstert.2013.07.1890.

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di Summa, Pietro G., William Watfa, Swenn Krähenbühl, Clara Schaffer, Wassim Raffoul, and Olivier Bauquis. "Colic-Based Transplant in Sexual Reassignment Surgery: Functional Outcomes and Complications in 43 Consecutive Patients." Journal of Sexual Medicine 16, no. 12 (2019): 2030–37. http://dx.doi.org/10.1016/j.jsxm.2019.09.007.

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27

De Cuypere, G., M. Van Hemelrijck, A. Michel, et al. "Prevalence and demography of transsexualism in Belgium." European Psychiatry 22, no. 3 (2007): 137–41. http://dx.doi.org/10.1016/j.eurpsy.2006.10.002.

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AbstractAimThe Belgian medical world has acknowledged the diagnosis of transsexualism and accepted Sex Reassignment Surgery (SRS) as one of the steps in the treatment of choice since 1985. This prevalence and demographic study analyses data on all Belgian individuals who have undergone SRS since that year.MethodsAll (188) plastic surgeons as well as all gender teams (Antwerp, Bruges, Ghent, and Liège) in Belgium were sent demographic questionnaires to be completed for each of their transsexual patients.ResultsThe results show an overall prevalence of 1:12,900 for male-to-female and 1:33,800 for female-to-male transsexuals in Belgium. In Wallonia (the French-speaking region of Belgium) the prevalence is significantly lower than in Flanders (the Dutch-speaking region) and in Brussels (the bilingual capital region). In the total Belgian population the male/female sex ratio is 2.43:1, again with a substantial difference between Wallonia on the one hand and Flanders on the other.Discussion and ConclusionWhile in Flanders and in Brussels the prevalence is comparable to that in other Western European countries, in Wallonia it is markedly lower. Transsexualism in Wallonia appears to be socially less acceptable: persons suffering from gender dysphoria in that part of Belgium encounter more problems accessing gender clinics and receiving treatment.
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Bellhouse, Clare, Sandra Walker, Christopher K. Fairley, et al. "Patterns of sexual behaviour and sexual healthcare needs among transgender individuals in Melbourne, Australia, 2011–2014." Sexually Transmitted Infections 94, no. 3 (2016): 212–15. http://dx.doi.org/10.1136/sextrans-2016-052710.

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ObjectiveLiterature surrounding the healthcare needs of transgender individuals is limited in Australia. This study aimed to investigate the demographic characteristics, risk behaviours and HIV/STI positivity among male-to-female (MTF) and female-to-male (FTM) transgender individuals attending Melbourne Sexual Health Centre (MSHC), Australia, between 2011 and 2014.MethodA retrospective cohort analysis for 133 transgender individuals was conducted based on the first visit of individuals to MSHC during the study period. Demographic characteristics, sexual behaviours and HIV/STI positivity were examined.ResultsThe majority of transgender individuals were single or never married (74%; n=99). Almost half of the individuals (47%; n=62) had ever engaged in sex work during their lifetime. The median number of male sexual partners (MSP) reported in the last 3 months was 1 (IQR: 1–2) and with female sexual partners (FSP) was 2 (IQR: 1–4). For those who reported having sexual partners in the previous 3 months, always using condoms with MSP was 31% (n=22), and that with FSP was 18% (n=2). HIV/STI positivity during the study period was 7% (n=8) for chlamydia, 5% (n=6) for gonorrhoea, 5% (n=5) for syphilis and 1% (n=1) for HIV. Hormone use for reassignment was reported by 63% (n=90) of individuals and reassignment surgery was reported by 27% (n=29+6=35).ConclusionsTransgender individuals in this study were found to be a diverse group, with a history of sex work being a common feature. These findings indicate that transgender individuals' sexual healthcare needs differ substantially from those in other countries, including the US and Canada. Attention to differences in MTF and FTM transgender persons must be considered in healthcare settings in Australia.
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Mate-Kole, Charles, Maurizio Freschi, and Ashley Robin. "A Controlled Study of Psychological and Social Change after Surgical Gender Reassignment in Selected Male Transsexuals." British Journal of Psychiatry 157, no. 2 (1990): 261–64. http://dx.doi.org/10.1192/bjp.157.2.261.

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Of two groups of 20 patients accepted for gender reassignment surgery, one was offered early operation and therefore had had surgery by follow-up two years later, while the second was still awaiting operation at two-year follow-up. Although the groups were similar initially, significant differences between them emerged at follow-up in terms of neuroticism and social and sexual activity, with benefits being enjoyed by the operated group.
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Bucci, Stefano, Giorgio Mazzon, Giovanni Liguori, et al. "Neovaginal Prolapse in Male-to-Female Transsexuals: An 18-Year-Long Experience." BioMed Research International 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/240761.

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Neovaginal prolapse is a rare and distressing complication after male-to-female sexual reassignment surgery. We retrospectively analysed the prevalence of partial and total neo-vaginal prolapses after sexual reassignment surgery in our institute. During the years, two different techniques have been adopted with the aim of fixing the neovaginal cylinder. In the first, two absorbable sutures are placed at the top of the penoscrotal cylinder and fixed to the Denonvilliers fascia. In the second, two additional sutures are added from the posterior/midpoint of the flap to the prerectal fascia. We enrolled 282 consecutive transsexual patients. 65 (23.04%) out of the 282 were treated with the first technique and the following 217 (76.96%) with the last technique. In the first technique, 1 case (1.53%) of total prolapse and 7 cases (10.76%) of partial prolapse were observed, while in the other 217 patients treated with the second technique only 9 cases of partial prolapse were observed (4.14%) and no cases of total prolapse. All prolapses occurred within 6 months from the procedure. In our experience, the use of 4 stitches and a more proximal positioning of the sutures to fix the penoscrotal apex with the Denonvilliers fascia guarantees a lower risk of prolapse.
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Vedovo, F., N. Pavan, G. Chiapparrone, G. Liguori, F. Barbone, and C. Trombetta. "403 Comparison of Sexual Function in Transsexual Women Who Underwent Sex Reassignment Surgery by Two Different Techniques." Journal of Sexual Medicine 14, no. 1 (2017): S122. http://dx.doi.org/10.1016/j.jsxm.2016.11.282.

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32

Burns, Alistair, Michael Farrell, and Jeremy Christie Brown. "Clinical Features of Patients Attending a Gender-Identity Clinic." British Journal of Psychiatry 157, no. 2 (1990): 265–68. http://dx.doi.org/10.1192/bjp.157.2.265.

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Of 106 patients attending a gender-identity clinic, 73% satisfied DSM–III criteria for transsexualism. These DSM–III positives had a significantly younger age of onset and were less likely to experience sexual arousal with cross-dressing than those who did not satisfy DSM–III criteria. They were also significantly more likely to fulfil a definition of ‘core transsexualism’. ‘Core transsexualism’ may represent a subgroup within DSM–III criteria for transsexualism and its defining features in this study were an early age of onset, low sexual activity, lack of sexual arousal with cross-dressing and homosexual orientation. Of the whole sample, 23% were referred for gender reassignment surgery, of whom 100% were DSM–III positive and 60% were ‘core transsexuals'.
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Subbaraj, Saravanakumar, Srinivasan, and Nivethaa. "Gender reassignment surgery: male to female, a short-term analysis of post-operative outcome." International Surgery Journal 4, no. 10 (2017): 3288. http://dx.doi.org/10.18203/2349-2902.isj20174175.

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Background: The term gender dysphoria describes a heterogenous group of individuals who express varying degree of dissatisfaction with their anatomical gender and the desire to possess the secondary sexual characteristics of the opposite sex. For these individuals, gender reassignment surgery (GRS) plays a pivotal role in relieving their psychological discomfort. The literature is limited in terms of the outcome of surgery. In this study, we present surgical outcome and post-operative complications in Male to Female GRS.Methods: This is a retrospective cohort study on consecutive patients who underwent male to female (MtF) GRS at the Department of General Surgery, Mahatma Gandhi Medical College and Research Institute, Puducherry, India from March 2015 to July 2017 and demographic profile along with surgical complications were registered and analysed.Results: During the study period, a total of 59 MtF GRS were performed. The median age of the patients was 25.4 years (range 19-39). Major complications like rectovaginal fistula and pulmonary embolisms and deep venous thrombosis were not observed. The most common complications were wound infection and reactionary bleeding from the urethra.Conclusions: Gender reassignment surgery plays a pivotal role in relieving the psychological discomfort of Gender Dysphoria individuals. MtF GRS can be performed with a low rate of complications. The collaborative effort between the surgeon, behavioural scientist, and a medical physician responsible for hormonal therapy is recommended. Our short-term analysis revealed the low rate of complications. Surgical experience is the key factor to minimize the complication rate.
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Zavlin, Dmitry, Jürgen Schaff, Jean-Daniel Lellé, et al. "Male-to-Female Sex Reassignment Surgery using the Combined Vaginoplasty Technique: Satisfaction of Transgender Patients with Aesthetic, Functional, and Sexual Outcomes." Aesthetic Plastic Surgery 42, no. 1 (2017): 178–87. http://dx.doi.org/10.1007/s00266-017-1003-z.

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Duišin, Dragana, Borjanka Batinić, Jasmina Barišić, Miroslav L. Djordjevic, Svetlana Vujović, and Marta Bizic. "Personality Disorders in Persons with Gender Identity Disorder." Scientific World Journal 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/809058.

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Background.Investigations in the field of gender identity disorder (GID) have been mostly related to psychiatric comorbidity and severe psychiatric disorders, but have focused less on personality and personality disorders (PDs).Aims.The aim of the study was to assess the presence of PDs in persons with GID as compared to cisgendered (a cisgender person is a person who is content to remain the gender they were assigned at birth) heterosexuals, as well as to biological sex.Methods.The study sample consisted of 30 persons with GID and 30 cisgendered heterosexuals from the general population. The assessment of PDs was conducted by application of the self-administered Structured Clinical Interview for DSM-IV Axis II PDs (SCID-II).Results.Persons with GID compared to cisgender heterosexuals have higher presence of PDs, particularly Paranoid PD, avoidant PDs, and comorbid PDs. In addition, MtF (transwomen are people assigned male at birth who identify as women) persons are characterized by a more severe psychopathological profile.Conclusions.Assessment of PDs in persons with GID is of great importance as it comprises a key part of personalized treatment plan tailoring, as well as a prognostic factor for sex-reassignment surgery (SRS) outcome.
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Vedovo, F., L. Di Blas, C. Perin, et al. "oMtFSFI: Operated male to female sexual function index. Development and validation of the first questionnaire to assess sexual function after male to female gender reassignment surgery." European Urology Supplements 18, no. 1 (2019): e1619-e1620. http://dx.doi.org/10.1016/s1569-9056(19)31173-x.

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Vedovo, F., L. Di Blas, C. Perin, et al. "oMtFSFI: Operated Male to Female Sexual Function Index. Development and validation of the first questionnaire to assess sexual function after male to female gender reassignment surgery." European Urology Supplements 17, no. 8 (2018): 202–3. http://dx.doi.org/10.1016/s1569-9056(18)33109-9.

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Costantino, Antonietta, Silvia Cerpolini, Stefania Alvisi, Paolo Giovanni Morselli, Stefano Venturoli, and Maria Cristina Meriggiola. "A Prospective Study on Sexual Function and Mood in Female-to-Male Transsexuals During Testosterone Administration and After Sex Reassignment Surgery." Journal of Sex & Marital Therapy 39, no. 4 (2013): 321–35. http://dx.doi.org/10.1080/0092623x.2012.736920.

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Spizzirri, G., E. T. Benatti, M. Farinas, et al. "O-24 Evaluation of Anxiety and Depressive Symptoms before Performing Sexual Reassignment Surgery in Transsexual Individuals with Gender Dysphoria - A Prospective Study." Journal of Sexual Medicine 14, no. 12 (2017): e379. http://dx.doi.org/10.1016/j.jsxm.2017.10.033.

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Vedovo, F., L. Di Blas, C. Perin, et al. "P-06-1 Operated Male to Female Sexual Function Index (OMTFSFI): A Study on the Validity of the First Questionnaire Developed in Order to Assess the Sexual Function after Male to Female Gender Reassignment Surgery." Journal of Sexual Medicine 17, no. 6 (2020): S207. http://dx.doi.org/10.1016/j.jsxm.2020.04.344.

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Salgado, Christopher J., Ajani Nugent, Joseph Kuhn, Meghan Janette, and Heidi Bahna. "Primary Sigmoid Vaginoplasty in Transwomen: Technique and Outcomes." BioMed Research International 2018 (2018): 1–7. http://dx.doi.org/10.1155/2018/4907208.

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Background. Many techniques have been described for reconstruction of the vaginal canal for oncologic, traumatic, and congenital indications. An increasing role exists for these procedures within the transgender community. Most often, inverted phallus skin is used to create the neovagina in transwomen. However, not all patients have sufficient tissue to achieve satisfactory depth and those that do must endure cumbersome postoperative dilation routines to prevent contracture. In selected patients, the sigmoid colon can be used to harvest ample tissue while avoiding the limitations of penile inversion techniques. Methods. Records were retrospectively reviewed for all transwomen undergoing primary sigmoid vaginoplasty with the University of Miami Gender Reassignment service between 2014 and 2017. Results. Average neovaginal depth was 13.9 +/− 2.0 centimeters in 12 patients. 67% were without complications, and all maintained tissue conducive to sexual activity. No incidences of bowel injury, anastomotic leak, sigmoid necrosis, prolapse, diversion neovaginitis, dyspareunia, or excessive secretions had occurred at last follow-up. Conclusions. Sigmoid vaginoplasty is a reliable technique for achieving a satisfactory vaginal depth that is sexually functional. Using a collaborative approach, it is now our standard of care to offer this surgery to transwomen with phallus length less than 11.4 centimeters.
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Saria, Vaibhav. "Begging for change: Hijras, law and nationalism." Contributions to Indian Sociology 53, no. 1 (2019): 133–57. http://dx.doi.org/10.1177/0069966718813588.

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This article begins by examining multiple drafts of a parliamentary legislation that aims to provide rights and reservations to transgender persons in India, so as to trace the ways in which hijras have been absorbed into the discourse of nationalism. The most current draft of this bill, ‘The Transgender Persons (Protection of Rights) Bill of 2016’ shows that despite claims to protect transgender citizens, the state uses the discourse of nationalism to justify the increased governmentalisation of hijra bodies and lives. I bring attention to the state’s insistence on the distance between homosexuals and hijras and the active endorsement of Sexual Reassignment Surgery to argue that the legislations are consolidating heterosexuality rather than making space for queer citizens. The project of heterosexualisation marks the disjuncture between colonial and contemporary ambitions of policing hijras, which have remained remarkably consistent and centred around their economic activity of begging. Based on ethnographic research conducted in rural Odisha, I question the glossing of hijras’ practice of seeking alms or challa as begging, to show how limits of nationalism are drawn and render hijra forms of being as incommensurable with the state.
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Hernandez Anton, R., C. Noval Canga, E. Rybak Koite, et al. "I am trapped in a wrong body." European Psychiatry 33, S1 (2016): S590. http://dx.doi.org/10.1016/j.eurpsy.2016.01.2199.

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IntroductionGender dysphoria is incoherence between the sex a person feels or expresses and the biological.ObjectiveRevise the inclusion criteria for hormone therapy and sex reassignment surgery in gender dysphoria. Expose the multidisciplinary approach. Make differential diagnosis with other psychological disorders.MethodologyA 45 years old male patient (biological female), who was sent from Endocrinology Unit for a psychiatric evaluation before restart a hormonal treatment. Since his childhood, he has presented dissatisfaction with his sexual characteristics; he has had fantasies and dreams, in which he belonged to the other sex. He has always chosen male activities and male stereotypes companies. He has presented preference for cross-dressing from 9 years. Always felt the sexual attraction for women. He first consulted for this reason in 1995.ResultsIt reported favorably to start hormone treatment after completing the eligibility criteria: > 18 years old; knowledge of the effects of hormones; and more 3 months documented real-life experience. The hormone therapy caused the growth of microprolactinoma, which was treated with dopamine agonists until it disappeared and the cessation of galactorrhea. Testosterone treatment is restarted. Laboratory tests are done every 3 months during the first year and then, every 6 months.ConclusionsIs the gender disphoria a pathology? The EU recommends a reclassification as no pathological disorders in ICD-11. The treatment of gender dysphoria is necessary, and there is no reason to postpone it. The main difficulty is the differential diagnosis; there may be comorbidity with others mental disorders which are not exclusive (psychotic disorder, OCD, personality disorders and other disorders of gender identity).Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Noland, Ramona M., Martha A. Bass, Rosanne S. Keathley, and Rowland Miller. "Is a Little Knowledge a Good Thing? College Students Gain Knowledge, but Knowledge Increase Does not Equal Attitude Change Regarding Same-Sex Sexual Orientation and Gender Reassignment Surgery in Sexuality Courses." American Journal of Sexuality Education 4, no. 2 (2009): 139–57. http://dx.doi.org/10.1080/15546120903001399.

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Costa, Elaine Maria Frade, and Berenice Bilharinho Mendonca. "Clinical management of transsexual subjects." Arquivos Brasileiros de Endocrinologia & Metabologia 58, no. 2 (2014): 188–96. http://dx.doi.org/10.1590/0004-2730000003091.

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Transsexual subjects are individuals who have a desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with, or inappropriateness of, one’s anatomic sex, and a wish to have surgery and hormonal treatment to make one’s body as congruent as possible with one’s preferred sex. They seek to develop the physical characteristics of the desired gender, and should undergo an effective and safe treatment regimen. The goal of treatment is to rehabilitate the individual as a member of society in the gender he or she identifies with. Sex reassignment procedures necessary for the treatment of transsexual patients are allowed in our country, at Medical Services that have a multidisciplinary team composed of a psychologist, a social worker, a psychiatrist, an endocrinologist and surgeons (gynecologists, plastic surgeons, and urologists). Patients must be between 21 to 75 years old and in psychological and hormonal treatment for at least 2 years. Testosterone is the principal agent used to induce male characteristics in female transsexual patients, and the estrogen is the chosen hormone used to induce the female sexual characteristics in male transsexual patients. Based on our 15 years of experience, we can conclude that testosterone and estradiol treatment in physiological doses are effective and safe in female and male transsexual patients, respectively.
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Baram, Shira, Samantha A. Myers, Samantha Yee, and Clifford L. Librach. "Fertility preservation for transgender adolescents and young adults: a systematic review." Human Reproduction Update 25, no. 6 (2019): 694–716. http://dx.doi.org/10.1093/humupd/dmz026.

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Abstract BACKGROUND Many transgender individuals choose to undergo gender-affirming hormone treatment (GAHT) and/or sex reassignment surgery (SRS) to alleviate the distress that is associated with gender dysphoria. Although these treatment options often succeed in alleviating such symptoms, they can also negatively impact future reproductive potential. OBJECTIVE AND RATIONALE The purpose of this systematic review was to synthesize the available psychosocial and medical literature on fertility preservation (FP) for transgender adolescents and young adults (TAYAs), to identify gaps in the current research and provide suggestions for future research directions. SEARCH METHODS A systematic review of English peer-reviewed papers published from 2001 onwards, using the preferred reporting items for systematic reviews and meta-analyses protocols (PRISMA-P) guidelines, was conducted. Four journal databases (Ovid MEDLINE, PubMed Medline, Ovid Embase and Ovid PsychINFO) were used to identify all relevant studies exploring psychosocial or medical aspects of FP in TAYAs. The search strategy used a combination of subject headings and generic terms related to the study topic and population. Bibliographies of the selected articles were also hand searched and cross-checked to ensure comprehensive coverage. All selected papers were independently reviewed by the co-authors. Characteristics of the studies, objectives and key findings were extracted, and a systematic review was conducted. OUTCOMES Included in the study were 19 psychosocial-based research papers and 21 medical-based research papers that explore fertility-related aspects specific for this population. Key psychosocial themes included the desire to have children for TAYAs; FP discussions, counselling and referrals provided by healthcare providers (HCPs); FP utilization; the attitudes, knowledge and beliefs of TAYAs, HCPs and the parents/guardians of TAYAs; and barriers to accessing FP. Key medical themes included fertility-related effects of GAHT, FP options and outcomes. From a synthesis of the literature, we conclude that there are many barriers preventing TAYAs from pursuing FP, including a lack of awareness of FP options, high costs, invasiveness of the available procedures and the potential psychological impact of the FP process. The available medical data on the reproductive effects of GAHT are diverse, and while detrimental effects are anticipated, the extent to which these effects are reversible is unknown. WIDER IMPLICATIONS FP counselling should begin as early as possible as a standard of care before GAHT to allow time for informed decisions. The current lack of high-quality medical data specific to FP counselling practice for this population means there is a reliance on expert opinion and extrapolation from studies in the cisgender population. Future research should include large-scale cohort studies (preferably multi-centered), longitudinal studies of TAYAs across the FP process, qualitative studies of the parents/guardians of TAYAs and studies evaluating the effectiveness of different strategies to improve the attitudes, knowledge and beliefs of HCPs.
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Pungrasmi, Pornthep, Jiraroch Meevassana, Kassaya Tantiphlachiva, et al. "Brief communication (Original). Anorectal physiology evaluation after male-to-female sex reassignment surgery." Asian Biomedicine 8, no. 6 (2014). http://dx.doi.org/10.5372/1905-7415.0806.359.

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AbstractBackground: Male-to-female sex reassignment surgery (MTF-SRS) is a treatment for gender identity disorders (GID) wherein the penis is removed and an epithelialized neovagina is created in the retroprostatic or rectovesical space. This is a space between the double layers of Denonvilliers’ fascia that contains motor, sensory, and autonomic nerves to the pelvic organs. Injury to these nerves may lead to anorectal dysfunction. However, there has been no objective study of anorectal physiologic changes after SRS.Objectives: To compare anorectal physiological parameters, before and after, male-to-female sex reassignment surgery (SRS) and to evaluate the effects of SRS on anorectal physiology.Methods: In 10 patients with MTF GID who underwent SRS at King Chulalongkorn Memorial Hospital, anorectal manometry was performed using a water perfused catheter (Mui Scientific, Ontario, Canada) and a state-of-the-art anorectal manometry system (Medtronic, Minneapolis, MN, USA) at the Gastrointestinal Motility Research Unit at 2 weeks before and 3 months after the SRS. Data were analyzed using PolygramNet software. Anal sphincter pressures (mmHg) with volume used to elicit rectal sensation (mL).Results: There was no significant change in the resting anal sphincter pressure, anal sphincter squeezing pressure, sustained squeezing pressure, and duration of squeeze, rectal sensation, and threshold of the desire to defecate affected by SRS. Cough reflex and rectoanal inhibitory reflex were normal both before and after SRS in all patient participants.Conclusions: Sex reassignment surgery seems to produce no effect on clinical anorectal functions. This was proven by absence of clinically significant changes in anorectal manometry.
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Morais, Andréia Vanessa Carneiro, and Helena Moraes Cortes. "Cirurgia de redesignação sexual: implicações para o cuidado / Sex reassignment surgery: implications for care." Journal of Nursing and Health 10, no. 3 (2020). http://dx.doi.org/10.15210/jonah.v10i3.16773.

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Objetivo: conhecer a produção científica nacional e internacional, de 2007 a 2017, acerca da cirurgia de redesignação sexual. Método: revisão integrativa realizada em duas bases de dados, em julho de 2018. Utilizou-se o ENDNOTE® para sistematizar os artigos. Resultados: a amostra foi composta por 18 artigos. Identificaram-se três categorias temáticas: “técnicas cirúrgicas”, “complicações operatórias” e “aspectos psicossociais”. Conclusões: pode-se constatar que a literatura científica tem buscado publicar estudos sobre novas técnicas cirúrgicas, as complicações operatórias e, os aspectos psicossociais que tendem a dar maior qualidade de vida às pessoas transgenitalizadas. Observou-se a necessidade de outros estudos científicos que versem sobre formas de cuidar, tanto na perspectiva de fornecer informações sobre o cuidado imediato e contínuo com o neofalo e a neovagina após a cirurgia de redesignação sexual como no que tange ao cuidado integral de pessoas transgêneras que se submetem à cirurgia de redesignação sexual.
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S, Draman, Maliya S, Syaffiq M, Hamizah Z, Abdul Hakim A, and MR Razman. "Mak Nyahs and Sex Reassignment Surgery – A Qualitative Study from Pahang, Malaysia." IIUM Medical Journal Malaysia 18, no. 1 (2020). http://dx.doi.org/10.31436/imjm.v18i1.223.

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Introduction: Mak nyahs are locally known male-to-female transgenders in Malaysia. In Western countries, medicalization of transgenderism allows strictly selected patients to undergo sex reassignment surgery. However, a standardized treatment system is not yet available in Malaysia. A number of mak nyahs underwent sex reassignment surgery at their own will. This study aimed to explore mak nyahs’ knowledge and perception on sex reassignment surgery. Materials and Methods: A qualitative research was carried out from 13th July 2016 till 31st August 2016 among 8 adult mak nyahs in Kuantan, Pahang. Snowball sampling was used. Participants who gave verbal consent were interviewed individually and in focus groups. Data obtained was transcribed and used as the primary data source. Results: All informants were Malays and Muslims. They generally had some knowledge about the standard procedures and risks in sex reassignment surgery. All informants expressed their desire to have the surgery, but chose not to. Reasons discouraging them from having the surgery were: i) religion, ii) forbiddance from family, iii) fear of regret, iv) death from surgery, and v) the lack of necessity. Factors driving them to have the surgery: i) more income from sex work, ii) pressure from sex clients, iii) securing a stable relationship, iv) self-satisfaction, and v) hope for a better future. Conclusion: Religion seemed to be the main reason refraining them from undertaking the surgery. Counselling mak nyahs should include the advantages and disadvantages of sexual reassignment surgery. Islamic religious preaching is very important to help reduce high risk behaviours, as well as teaching mak nyahs to cope with challenges in adult life. Further research is necessary to show association between religious knowledge and successful rehabilitation of the mak nyahs’ community.
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Dr. Muhammad Yaseen and Dr. Muhammad Shahid. "The legality of Artificial sex change in Islamic perspective." rahatulquloob, January 1, 2021, 19–26. http://dx.doi.org/10.51411/rahat.5.1.2021/146.

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Humans and diseases are related to each other since the creation. With the passage of time, humans were able to overcome different diseases. But still, they could not find out the solution for those people who were born in wrong bodies. The progress of medical science ultimately enabled them to restore their originality through corrective surgery or sex reassignment surgery. But soon this was also misused like the other researches by opportunists. The people who were healthy and have developed sexual organs got their sex change artificially without knowing the religious aspects. This article will highlight the Islamic aspects of artificial sex change surgery.
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