Gender identity disorder or transsexualism is a complex clinical condition, and prevailing
social context strongly impacts the form of its manifestations. Sex reassignment surgery
(SRS) is the crucial step of a long and complex therapeutic process starting with
preliminary psychiatric evaluation and culminating in definitive gender identity conversion.
The aim of our study is to arrive at a clinical and psychosocial profile of male-to-female
transsexuals in Italy through analysis of their personal and clinical experience and
evaluation of their postsurgical satisfaction levels SRS.
From January 1992 to September 2006, 163 male patients who had undergone gender-transforming
surgery at our institution were requested to complete a patient satisfaction questionnaire.
The questionnaire consisted of 38 questions covering nine main topics: general data,
employment status, family status, personal relationships, social and cultural aspects,
presurgical preparation, surgical procedure, and postsurgical sex life and overall
satisfaction.
Average age was 31 years old. Seventy-two percent had a high educational level, and
63% were steadily employed. Half of the patients had contemplated suicide at some
time in their lives before surgery and 4% had actually attempted suicide. Family and
colleague emotional support levels were satisfactory. All patients had been adequately
informed of surgical procedure beforehand. Eighty-nine percent engaged in postsurgical
sexual activities. Seventy-five percent had a more satisfactory sex life after SRS,
with main complications being pain during intercourse and lack of lubrication. Seventy-eight
percent were satisfied with their neovagina's esthetic appearance, whereas only 56%
were satisfied with depth. Almost all of the patients were satisfied with their new
sexual status and expressed no regrets.
Our patients' high level of satisfaction was due to a combination of a well-conducted
preoperative preparation program, competent surgical skills, and consistent postoperative
follow-up.