title: Transsexualism in Serbia: a twenty-year follow-up study.
abstract: BACKGROUND
  Gender dysphoria occurs in all societies and cultures. The prevailing social context has a strong impact on its manifestations as well as on applications by individuals with the condition for sex reassignment treatment.
  
  
  OBJECTIVE
  To describe a transsexual population seeking sex reassignment treatment in Serbia, part of former Yugoslavia.
  
  
  METHODS
  Data, collated over a period of 20 years, from subjects applying for sex reassignment to the only center in Serbia, were analyzed retrospectively.
  
  
  METHODS
  Age at the time of application, demographic data, family background, sex ratio, the prevalence of polycystic ovarian syndrome (PCOS) among female-to-male (FTM) transsexuals, and readiness to undergo surgical sex reassignment were tabulated.
  
  
  RESULTS
  Applicants for sex reassignment in Serbia are relatively young. The sex ratio is close to 1:1. They often come from single-child families. More than 10% do not wish to undergo surgical sex reassignment. The prevalence of PCOS among FTM transsexuals was higher than in the general population but considerably lower than that reported in the literature from other populations. Of those who had undergone sex reassignment, none expressed regret for their decision.
  
  
  CONCLUSIONS
  Although transsexualism is a universal phenomenon, the relatively young age of those applying for sex reassignment and the sex ratio of 1:1 distinguish the population in Serbia from others reported in the literature.
authors.affiliation: Belgrade Team for Gender Identity Disorders, Institute of Endocrinology, Clinical Center of Serbia, Belgrade, Serbia;. Electronic address: vujovics@EUnet.yu.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Vujovic
authors.affiliation: Institute of Endocrinology, Belgrade, Serbia.
authors.forename: Srdjan
authors.initials: S
authors.lastname: Popovic
authors.affiliation: Institute of Hygiene and Medical Ecology, Belgrade, Serbia.
authors.forename: Gorica
authors.initials: G
authors.lastname: Sbutega-Milosevic
authors.affiliation: University Children's Hospital, Belgrade, Serbia.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Djordjevic
authors.affiliation: Gender Clinic, Vrije Universiteit University Hospital, Amsterdam, The Netherlands.
authors.forename: Louis
authors.initials: L
authors.lastname: Gooren
mesh_terms: D000293:Adolescent; D000328:Adult; D005190:Family / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007621:Karyotyping; D008297:Male; D011085:Polycystic Ovary Syndrome / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D055771:Serbia / Q000453:epidemiology; D013997:Time Factors; D014189:Transsexualism / Q000453:epidemiology*; D014427:Twins / Q000235:genetics; D055815:Young Adult