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At least 19 recordsLinked to original sources
PubMed1996

Transsexualism--general outcome and prognostic factors: a five-year follow-up study of nineteen transsexuals in the process of changing sex.

Nineteen transsexuals, approved for sex reassignement, were followed-up after 5 years. Outcome was evaluated as changes in seven areas of social, psychological, and psychiatric functioning. At baseline the patients were evaluated according to axis I, II, V (DSM-III-R), SCID screen, SASB (Structural Analysis of Social Behavior), and DMT (Defense Mechanism Test). At follow-up all but 1 were treated with contrary sex hormones, 12 had completed sex reassignment surgery, and 3 females were waiting for phalloplasty. One male transsexual regretted the decision to change sex and had quit the process. Two transsexuals had still not had any surgery due to older age or ambivalence. Overall, 68% (n = 13) had improved in at least two areas of functioning. In 3 cases (16%) outcome were judged as unsatisfactory and one of those regarded sex change as a failure. Another 3 patients were mainly unchanged after 5 years. Female transsexuals had a slightly better outcome, especially concerning establishing and maintaining partnerships and improvement in socio-economic status compared to male transsexuals. Baseline factors associated with negative outcome (unchanged or worsened) were presence of a personality disorder and high number of fulfilled axis II criteria. SCID screen assessments had high prognostic power. Negative self-image, according to SASB, predicted a negative outcome, whereas DMT variables were not correlated to outcome.

Adult↗
PubMed1989

Evidence for several fold more activity of NAD+-dependent uterine prostaglandin 15-hydroxydehydrogenase in transsexual than in non-transsexual women.

The activity of NAD+-dependent PGDH was measured in the cytosolic fractions (100,000 x g) of uterine tissues obtained from transsexual, pregnant and non-pregnant women. The specific activity (mean +/- SD) of the enzyme at maximum velocity of the enzyme reaction in these three groups of women was 5.5 +/- 2.30, 0.53 +/- 0.27 and 0.54 +/- 0.25 mU/mg protein respectively using PGE2 as substrate, and with PGF2 alpha as substrate the respective values were 5.48 +/- 2.80, 0.49 +/- 0.41 and 0.51 +/- 0.30 mU/mg protein. These data suggest that, with either substrate, the uterine enzyme activity in the transsexuals was about 10-fold greater than in pregnant and non-pregnant women (p less than 0.001). However, the Km values of the enzyme for both PGE2 and PGF2 alpha were similar in all three groups, indicating the presence of same enzyme in the uterus of transsexual, pregnant and non-pregnant women. We speculate that PGDH activity was raised in the uterus of transsexual women because of the prolonged androgen therapy they received for the management of female-to-male transsexualism.

Adult↗
PubMed1996

Transsexualism in Portugal: the legal framework and procedure, and its consequences for transsexuals.

Sex reassignment surgery (SRS) in transsexuals is not allowed under Portuguese law which means that individuals have turned for aid to other countries to achieve the corresponding bodily 'correction'. Furthermore, those who submitted to SRS abroad suffered a stressful experience involving an unpredictable outcome when they asked for a subsequent change of their civil status records so as to update the data concerning sex and forename in their birth certificate and identity papers. In the last few years some people, especially doctors, have been taking steps to remove political, judicial and medical prejudices and attitudes in relation to the transsexuals' situation in this country; however, the main obstacles and procedures remain practically unchangeable. Based upon their medico-legal experience in such cases, the authors point out some aspects related to the situation of the transsexuals examined at the Institute of Legal Medicine of Lisbon since 1982, as well as their judicial outcome. In order to draw attention to the present situation of transsexuals within the Portuguese legal framework, this is compared with those of other European Union countries. Recognizing that this situation has become a heavy burden for transsexuals, the urgent necessity for Portugal to follow the main principles of Recommendation 1117 (1989) of the Parliamentary Assembly of the Council of Europe is stressed.

Adult↗
PubMed1999

[Transsexualism and schizophrenic psychosis. Problems preparing expert opinion on transsexualism].

We report on two schizophrenics with transsexual beliefs to illustrate the problems in nosological classification of these patients and the difficulties in preparing expertises on changing the first name or on the legal changing of sex status according to the German Transsexuals Act (TSG). We should differentiate between rare cases of true comorbidity of schizophrenia and transsexualism, and other patients in whom the transsexual wish presents as a symptom of psychosis. Before approving any legal changes or even sex reassignment surgery, the transsexual wish should have remained unchanged under otherwise successful antipsychotic treatment. Moreover, the patients must be able to translate into reality the desired sexual role in their social environment.

Adolescent↗
PubMed1986

Endocrine evaluation of forty female-to-male transsexuals: increased frequency of polycystic ovarian disease in female transsexualism.

A retrospective study of 40 female-to-male transsexuals was performed to investigate the frequency of endocrine dysfunction prior to hormonal treatment with testosterone. Two patients had laparoscopic evidence of polycystic ovarian disease (PCOD) prior to androgen treatment. Nine additional subjects had clinical evidence of PCOD, including ultrasonographic evidence of multicystic and enlarged ovaries in three patients and/or evidence of hirsutism and oligomenorrhea associated with increased androgen levels and/or an increased plasma luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratio. Two subjects had evidence of gonadal dysgenesis. Plasma levels of testosterone, prolactin, LH/FSH ratio, and dehydroepiandrosterone sulfate were significantly increased in 30 female transsexuals prior to testosterone treatment when compared to normal adult female controls studied in the early follicular phase of the menstrual cycle. These data indicate that female transsexuals have an increased incidence of endocrine dysfunction (32.5%) which should be investigated prior to hormonal treatment.

Adolescent↗
PubMed1996

Transsexualism in Germany: empirical data on epidemiology and application of the German Transsexuals' Act during its first ten years.

In light of possible emulation of the German Transsexuals' Act (TSG) in discussions taking place on future legislation in other states, on the 10th anniversary of the German TSG, we review the application of this law, as well as epidemiological data arising from its use. From 1981 to 1990, 1422 judicial decisions were rendered in Germany on this basis: 683 of them related to the so-called "small solution" (change of first name), and 733 involved what is termed the "major solution" (legal change of sex status). The frequency of transsexual applications over these 10 years lay between 2.1 and 2.4 per 100,000 German adult population. The average age was 33. Only 3.6% and 10.9% of the small and major applications, respectively, were rejected by courts. The sex ratio was 2.3:1 in favor of male-to-female transsexuals. Data revealed no significant trend over the years among the prevailing practices of adjudication, but evidence does exist that the German courts apply the law differently on a regional basis. Over the 10-year period, only six persons requested to have their names changed back again and only one to be reassigned to the former legal sex classification. Those who change their first names in the sense of a tentative accustomizing process waited an average of 2 years before changing their gender. Between 20 and 30% apparently went no further than the so-called "small solution."

Adult↗
PubMed1985

A psychological comparison of heterosexuals, transvestites, preoperative transsexuals, and postoperative transsexuals.

The psychological functioning of male heterosexuals, transvestites, preoperative transsexuals and postoperative transsexuals was assessed. The groups represented a gradient of progressive feminization which showed progressive levels of psychological dysfunction. The data indicated that the transsexuals studied were indicative of a select group demonstrating profound psychological dysfunction. The study contributes to the recent literature, which indicates that sex reassignment surgery for this group is not the treatment of choice. Criteria for projecting postoperative outcome are outlined which can be utilized to direct gender dysphoria patients to alternate treatments.

Adult↗
PubMed1980

The transsexual dilemma: being a transsexual.

With few exceptions, a solution to any problem will bring new difficulties. These may or may not be worse than the original problem, and one must decide, not between problem and answer, but between degrees of difficulty. Is the new situation really going to be better than the last? This is undoubtedly the situation with the transsexual. It is undeniable that in the majority of cases the treated transsexual is an infinitely happier person than the one who has not undergone therapy, but as a result of this treatment there arises a host of new difficulties. Using personal experience, it is my intention to illustrate the problems which beset the transsexual before, during and after treatment. It will then be possible to ascertain whether or not, in spite of these difficulties, there is in fact a dilemma. Is there indeed any choice?

Attitude↗
PubMed1977

The transsexual client: a discussion of transsexualism and issues in psychotherapy.

Transsexuals, as a client group, are increasingly coming to the attention of mental health professionals. This paper offers a general discussion of gender dysphoria and sex-reassignment, including an examination of their psychosocial aspects. The role of psychotherapy in relation to this client group is explored, and reactions of the therapist to the transsexual are considered.

Attitude of Health Personnel↗
PubMed2002

Masculinity, femininity, and transsexualism.

This study examined the relationship between sex role and gender identity in a Polish transsexual population where, unlike in Western countries, male-to-female (MF) transsexualism is much less common than female-to-male (FM) transsexualism. One hundred and three FM (82 primary, 21 secondary) and 29 MF (16 primary, 13 secondary) transsexuals plus 135 control males (CM) and 303 control females (CF) completed a Sex Role Inventory, which measures sex-role identification, that is, the degree to which one self-identifies with masculine and feminine characteristics. Data obtained from primary transsexuals revealed that, on a femininity scale, MF transsexuals scores exceeded not only CM but also CF. On a masculinity scale, MF transsexuals rated themselves significantly lower than CM, but at a level comparable to CF. The comparison of FM transsexuals and controls showed that, on a masculinity scale, transsexuals scored higher than CF but were not different from CM. On the femininity scale, FM transsexuals rated themselves in between the two control groups: lower than CF but slightly higher than CM. The relations of secondary transsexuals' scores to CF and CM scores, on both masculine and feminine scales, were in the same direction as the primary transsexuals' scores. Secondary transsexuals rated themselves very similarly to their primary counterparts (the exception was a much higher score of MF-primary transsexuals than MF-secondary transsexuals on the femininity scale). Our study revealed that transsexualism does not imply a simple inversion of sex-role patterns: transsexuals differ not only from nontranssexual individuals of the same anatomical sex but also from those of the opposite sex. Moreover, MF transsexualism is not a mirror image of FM transsexualism: it constitutes a more extreme condition in the identification with feminine versus masculine personality traits. These differences seem to be universal for different countries and regions. The diagnostic value of our findings is discussed.

Adult↗
PubMedDate not supplied

[Personality tests and gender identification in male transsexuals].

The aim of this research project was to study gender identification in male transsexuals compared to male and female controls, using the Rorschach test and the MMPI. In the international literature, many researches have shown that the nature of the human response on Rorschach card III is linked to gender identification, as is the MMPI Mf scale. Ten untreated male homosexual transsexuals and 18 treated and operated male homosexual transsexuals were compared to 10 male and 12 female controls regarding verbal IQ, human content on Rorschach card III and the MMPI Mf scale. Absence of hormonal treatment for the first group of transsexuals was checked by a blood test at the time of the psychological testing. Responses on Rorschach card III were scored according to different kinds of human contents: male (M), female (F), gender-unidentified/neutral (N), bisexual (B), feminine then masculine or the opposite (M/F), and nonhuman (NH). N, B, M/F and NH responses were rare in all Rorschach protocols. As expected, responses given by participants in the control group were significantly more consistent with their anatomical sex than with the opposite sex. Untreated transsexuals do not differ from treated and operated transsexuals on Rorschach data, and both transsexual groups give significantly more female human representations than male controls. Transsexuals' results are similar to female controls. Untreated transsexuals' mean score on the MMPI Mf scale is significantly higher than that of treated and operated transsexuals' score, in the male profile (biological sex). Both groups of transsexuals score higher on the Mf scale in the male profile than in the female profile. The mean Mf score in the male profile is significantly higher than that of male controls, whereas, in the female profile, the mean Mf score is similar to that of female controls. This study shows that for both groups of transsexuals, results are homogenous in respect of Rorschach and MMPI, showing hyper-conformism to self-perceived gender. Results in both groups are similar to results of female controls, but tend to show even more feminine gender identification. The absence of any significant difference between untreated and treated and operated transsexuals seems surprising, suggesting that the hormonal treatment has not had a major impact on gender identification processes. It would doubtless be interesting to study gender identification using even more kinds of data: all human contents in the Rorschach protocol (not just the responses given to card III), MMPI Mf scale, Draw-A-Person Test and Animal-and-Opposite Drawing Test. This would enhance result liability and could provide useful information about how gendter identification processes evolve after surgical sex reassigment.

Adult↗
PubMed1979

[Transsexualism and its therapy].

After a review of the historical development of ideas about transsexualiam and the discussion of possible somatic and psychological causes of this condition, the results of explorations of 12 male and 6 female transsexuals who desired a hormonal and surgical approximation to the opposite sex are reported. Two of the nine patients whose chromosomes were examined were found to suffer from Klinefelter's Syndrome. From the personal history it was apparent that 8 of the 12 male transsexuals had difficulty in identifying with an absent, alcoholic or brutal father. The wish to be a member of the opposite sex could be traced in 10 of the 12 male and all 6 female transsexuals to the first five years of life. 7 of the 12 male transsexuals and 3 of the 6 female transsexuals were found to have attempted suicide or to have had suicidal tendencies in the past. In 9/12 male transsexuals and 5/6 female transsexuals the "change of sex" operation was considered to be indicated. The average age at operation was 28 for the male transsexuals and 26 for the female transsexuals. The follow-up studies were done 2 months to 3 years after operation for the male transsexuals (average 1, 7 years) and 2 to 3 3/4 years post operatively (average 2, 9 years) for the female transsexuals. 7/8 of the male transsexuals from whom we have katamneses and both female transsexuals reported that they felt subjectively better than before the operation. The present legal situation concerning the registration of change of name and sex in various countries is described.

Adolescent↗
PubMed1987

Transsexuals who have not undergone surgery: a follow-up study.

Transsexuals who had not undergone surgery, although it had been offered to them providing they fulfilled the usual requirements, were classified into various subgroups, measured according to their attitude towards sex reassignment surgery: they were transsexuals with an unaltered wish for surgery, transsexuals who were ambivalent towards surgery (hesitating patients), and transsexuals who had relinquished their wish for surgery and lived in the initial gender role. Whereas transsexuals with an unaltered wish for surgery did not differ substantially from transsexuals who had had surgery, the hesitating patients were noticeably older, more often married, more often had children of their own, their partnerships were of long duration, and exclusively with partners of the opposite biological sex. These characteristics were seen when the diagnosis was first made. They can therefore be considered prognostic criteria for this subgroup. Transsexuals who relinquished their wish for surgery did not differ substantially from transsexuals with an unaltered wish for surgery. The reasons for relinquishing the wish for surgery were individual or could not be clearly established. At the time of follow-up, all transsexuals who had not undergone surgery indicated that they were experiencing the same degree of difficulty with respect to social adjustment as at the time of diagnosis. Slight improvements were seen in patients with an unaltered wish for surgery. Significant changes were seen only in transsexuals who had surgery. Transsexuals who have not had surgery and have no present wish for it are in the minority. Hesitating patients have a particular need for psychotherapy.

Adult↗