Quality of life in people with transsexuality after surgery: a systematic review and meta-analysis

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Abstract

Background

Several reports have demonstrated varying results on the quality of life (QoL) of the transgender population. Therefore, the aim of this study was to conduct a systematic review and meta-analysis about the quality of life (QoL) of individuals during the post transsexual surgery period.

Methods

We searched major biomedical electronic databases, including Scopus, Google Scholar, Psychological Information Database (PsycInfo), Web of Science, PubMed, Excerpta Medica dataBASE (EMBASE), and ProQuest, for all relevant literature published in English up to December 2019. The included papers required to be cross sectional studies that reported quality of life in people with transsexuality post surgery. After selecting eligible studies, 2 authors extracted data of each study independently and resolved any inconsistency by consensus with the third reviewer. The risk of bias was assessed by 2 independent research experts by the Newcastle-Ottawa Scale (NOS).

Results

In this study, out of 497 articles extracted from the initial investigation, 8 articles with 1099 patients were ultimately selected for meta-analysis. The pooled mean of quality of life in transsexual individuals was obtained to be 70.45 (95%CI 55.87–85.03) and 59.17 (95%CI 48.59–69.74), based on World Health Organization Quality of Life (WHOQoL-BREF) and The 36-item short form of the Medical Outcomes Study questionnaire (SF36), respectively. Also, the results of the subgroup analysis for the weighted mean quality of life in male to female and female to male showed that the mean quality of life in female to male was 57.54 (95%CI 42.24–72.84) and it was 62.47 (95%CI 45.94–79.00) in male to female, based on SF36 questionnaire. Moreover, the weighted mean quality of life in female to male was 69.99 (95%CI 43.76, 96.23) and it was 70.65 (95%CI 53.11, 88.19) in male to female, based on WHOQoL-BREF questionnaire.

Conclusion

The results of this systematic review may support the approaches to transsexuality that facilitates sex reassignment. In this review, the means of quality of life after surgery were not compared to the means of quality of life before surgery or even before hormonal therapy which was due to inadequate number of primary studies.

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Most cited references 40

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"I don't think this is theoretical; this is our lives": how erasure impacts health care for transgender people.

Greta Bauer, Rebecca Hammond, Robb Travers … (2009)

For people who are transgender, transsexual, or transitioned (trans), access to primary, emergency, and transition-related health care is often problematic. Results from Phase I of the Trans PULSE Project, a community-based research project in Ontario, Canada, are presented. Based on qualitative data from focus groups with 85 trans community members, a theoretical framework describing how erasure functions to impact experiences interacting with the health care system was developed. Two key sites of erasure were identified: informational erasure and institutional erasure. How these processes work in a mutually reinforcing manner to erase trans individuals and communities and produce a system in which a trans patient or client is seen as an anomaly is shown. Thus, the impetus often falls on trans individuals to attempt to remedy systematic deficiencies. The concept of cisnormativity is introduced to aid in explaining the pervasiveness of trans erasure. Strategies for change are identified.

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Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study.

Annelou L C de Vries, Thomas Steensma, Theo A H Doreleijers … (2011)

Puberty suppression by means of gonadotropin-releasing hormone analogues (GnRHa) is used for young transsexuals between 12 and 16 years of age. The purpose of this intervention is to relieve the suffering caused by the development of secondary sex characteristics and to provide time to make a balanced decision regarding actual gender reassignment.

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Psychiatric impact of gender-related abuse across the life course of male-to-female transgender persons.

Sel Hwahng, Jeffrey Becker, L Nuttbrock … (2009)

The psychiatric impact of interpersonal abuse associated with an atypical presentation of gender was examined across the life course of 571 male-to-female (MTF) transgender persons from the New York City Metropolitan Area. Gender-related abuse (psychological and physical), suicidality, and Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision) major depression were retrospectively measured across five stages of the life course using the Life Chart Interview. Among younger respondents (current age of 19-39), the impact of both types of abuse on major depression was extremely strong during adolescence and then markedly declined during later stages of life. Among older respondents (current age of 40-59), the impact of both types of abuse on major depression was strong during adolescence and then marginally declined during later stages of life. The effects of both types of abuse on suicidality were weaker but more consistently observed across the life course among both the younger and older respondents. Gender-related abuse is a major mental health problem among MTF transgender persons, particularly during adolescence. As these individuals mature, however, the consequences of this abuse appear less severe, which may represent the development of moderately effective mechanisms for coping with this abuse.

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Author and article information

Contributors

Mehrdad Eftekhar Ardebili: Eftekharardebili.m@iums.ac.ir

Leila Janani: Janani.l@iums.ac.ir

Zaher Khazaei: zaherkhazaei@yahoo.com

Yousef Moradi:

ORCID: http://orcid.org/0000-0002-2936-5930

Yousefmoradi211@yahoo.com

Hamid Reza Baradaran: baradaran.hr@iums.ac.ir , hamid.baradaran@abdn.ac.uk

Journal

Journal ID (nlm-ta): Health Qual Life Outcomes

Journal ID (iso-abbrev): Health Qual Life Outcomes

Title: Health and Quality of Life Outcomes

Publisher: BioMed Central (London )

ISSN (Electronic): 1477-7525

Publication date (Electronic): 3 August 2020

Publication date PMC-release: 3 August 2020

Publication date Collection: 2020

Volume: 18

Electronic Location Identifier: 264

Affiliations

[1 ]GRID grid.411746.1, ISNI 0000 0004 4911 7066, Mental Health Research Center, Psychosocial Health Research Institute (PHRI), , Iran University of Medical Science, ; Tehran, Iran

[2 ]GRID grid.411746.1, ISNI 0000 0004 4911 7066, Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute (PHRI), , Iran University of Medical Sciences, ; Tehran, Iran

[3 ]Department of Public Health, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran

[4 ]GRID grid.484406.a, ISNI 0000 0004 0417 6812, Social Determinants of Health Research Center, , Research Institute for Health Development, Kurdistan University of Medical Sciences, ; Sanandaj, Iran

[5 ]GRID grid.411746.1, ISNI 0000 0004 4911 7066, Endocrine Research Center, , Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), ; Tehran, Iran

[6 ]Ageing Clinical & Experimental Research Team, Institute of Applied Health Sciences, Aberdeen, Scotland AB25 2ZD UK

Author information

Yousef Moradi http://orcid.org/0000-0002-2936-5930

Article

Publisher ID: 1510

DOI: 10.1186/s12955-020-01510-0

PMC ID: 7397654

PubMed ID: 32746856

SO-VID: 80c4d335-932a-4caf-9d38-91bf71906635

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 16 December 2018

Date accepted : 24 July 2020

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: male to female,female to male,quality of life,whoqol-bref,sf36,transsexual individuals

Data availability:

ScienceOpen disciplines: Health & Social care

Keywords: male to female, female to male, quality of life, whoqol-bref, sf36, transsexual individuals

Quality of life in people with transsexuality after surgery: a systematic review and meta-analysis

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Asian Journal of Quality of Life (AjQoL)

Most cited references 40

"I don't think this is theoretical; this is our lives": how erasure impacts health care for transgender people.

Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study.

Psychiatric impact of gender-related abuse across the life course of male-to-female transgender persons.

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