Monday, 11 May 2009

SRS Results

A comment by Priya Lynn in the box turtle bulletin that is just too good not to quote entire (with a few links changed, one added, and some references cleared up).
From Alas, a Blog : Does sexual reassignment surgery work? from as far back as 2003:
The most comprehensive study of post-SRS outcomes is “Sex Reassignment. Thirty Years of International Follow-up Studies” by Friedemann Pfaefflin and Astrid Junge (1992 in German, English translation 1998). Pfaefflin and Junge used data from over 70 studies, in total considering the outcomes of over 2000 patients from 13 countries. They found that outcomes - measured in terms of “subjective satisfaction; mental stability; socioeconomic functioning; and partnership and sexual experience” - of SRS are generally positive. Overall, 71% of male-to-female (MTF) and 90% of female-to-male (FTM) operations had positive results. When they limited their sample only to more recent patients (who benefited from improvements in techniques and procedures over the decades), the results were positive for 87% of MTFs and 97% for FTMs.
That study is now over 10 years old and two more recent studies have shown 100% satisfaction rates:

The Reported Sex and Surgery Satisfactions of 28 Postoperative Male-to-Female Transsexual Patients by Jamil Rehman, Simcha Lazer, Alexandru E. Benet, Leah C. Schaefer and Arnold Melman Archives of Sexual Behavior, Vol. 28, 1999
From 1980 to July 1997 sixty-one male-to-femalegender transformation surgeries were performed at our university center by one author (A.M.). Data were collected from patients who had surgery up to 1994 (n = 47) to obtain a minimum follow-up of 3years; 28 patients were contacted. A mail questionnaire was supplemented by personal interviews with 11 patients and telephone interviews with remaining patients to obtain and clarify additional information.Physical and functional results of surgery were judged to be good, with few patients requiring additional corrective surgery. General satisfaction was expressed over the quality of cosmetic (normal appearing genitalia) and functional (ability to perceive orgasm)results. Follow-up showed satisfied who believed they had normal appearing genitalia and the ability to experience orgasm. Most patients were able to return to their jobs and live a more satisfactory social and personal life. One significant outcome was the importance of proper preparation of patients for surgery and especially the need for additional postoperative psychotherapy. None of the patients regretted having had surgery. However, some were, to a degree, disappointed because of difficulties experienced postoperatively in adjusting satisfactorily as women both in their relationships with men and in living their lives generally as women. Findings of this study make a strong case for making a change in the Harry Benjamin Standards of Care to include a period of postoperative psychotherapy.

Factors associated with satisfaction or regret following male-to-female sex reassignment surgery. by Anne A. Lawrence Archives of Sexual Behavior 01 August 2003
Abstract
This study examined factors associated with satisfaction or regret following sex reassignment surgery (SRS) in 232 male-to-female transsexuals operated on between 1994 and 2000 by one surgeon using a consistent technique. Participants, all of whom were at least 1-year postoperative, completed a written questionnaire concerning their experiences and attitudes. Participants reported overwhelmingly that they were happy with their SRS results and that SRS had greatly improved the quality of their lives. None reported outright regret and only a few expressed even occasional regret. Dissatisfaction was most strongly associated with unsatisfactory physical and functional results of surgery. Most indicators of transsexual typology, such as age at surgery, previous marriage or parenthood, and sexual orientation, were not significantly associated with subjective outcomes. Compliance with minimum eligibility requirements for SRS specified by the Harry Benjamin International Gender Dysphoria Association was not associated with more favorable subjective outcomes. The physical results of SRS may be more important than preoperative factors such as transsexual typology or compliance with established treatment regimens in predicting postoperative satisfaction or regret.

Orgasm in the postoperative transsexual. by Lief HI, Hubschman L. Arch Sex Behav. 1993 Apr;22(2):145-55.
Abstract
The dearth of information regarding orgasm in postoperative transsexuals prompted the authors to study its prevalence. The sample consisted of 14 male-to-female (M—F) and 9 female-to-male (F—M) postoperative transsexuals. The relationship of orgasm to sexual and general satisfaction was explored via a specially designed questionnaire. Orgastic capacity declined in the M—F group and increased in the (F—M) group. Despite the decrease in orgasm in the M—F group, satisfaction with sex and general satisfaction with the results of surgery were high in both groups. General satisfaction of 86% replicates other studies. Frequency of sex increased by 75% in the M—F group and by 100% in the F—M group. A phalloplasty does not appear to be a critical factor in orgasm or in sexual satisfaction. The general conclusion is reached that it is possible to change one’s body image and sexual identity and be sexually satisfied despite inadequate sexual functioning.
I won't comment other than to say that my own personal experience is consistent with these findings. *giggle*

I'm filing this one under "reference" so the next time someone makes comments somewhere about "I heard somewhere that most people regretted surgery.." I can refer them to the actual, you know, facts.

Of course genital reconstruction won't help with the persecution, the legal problems, the danger of being assaulted, being thrown out of your church (or your family) and so on. But then, transitioning and not having it would lead to the same problems, only worse. The remedy for this is not to prohibit surgery, but to, if not prohibit, at least discourage the persecution, by education and if need be, by legal means too. That's how you overcome the worst effects of unreasoning prejudice and bigotry. Time does the rest.

5 comments:

Mercedes said...

You'll want to keep an eye on the press around this, then, sort of in your neighborhood: http://www.theaustralian.news.com.au/story/0,25197,25459110-23289,00.html

Any idea if this has anything to do with the Monash clinic restructuring? I've been following what little I can find of that, as it looks reminiscent of something here a few years ago.

sumptos devil s advocate said...

http://www.commercialappeal.com/news/2009/may/11/tell-hot-button-what-you-think/

About the anti-discrimination ordinance.

Zoe Brain said...

Mercedes - there seems little doubt that 10 years ago, the Monash centre didn't follow the best practices in all cases. They got gulled by a number of people who deliberately lied, and are now complaining about the fact that they were believed.

This makes the 3rd case, out of several hundred transitions.

The Monash centre is being effectively shut down, as it's too easy a target. For the last few years, it's been more of an information clearinghouse than a clinic anyway, referring people to third parties for evaluation and treatment.

Bad hair days said...

Thats the fun thing. If the Drs wouldn't take away the patients right to decide about their body they wouldn't be accountable for misstreatment in the first place.

Nica said...

In some cases orgastic ability goes through the roof, so to speak, for mtf's. Almost to the point of being too much. Post-operative counseling is definitely a good idea.