title: Long-term assessment of the physical, mental, and sexual health among transsexual women.
abstract: BACKGROUND
  Transsexualism is the most extreme form of gender identity disorder and most transsexuals eventually pursue sex reassignment surgery (SRS). In transsexual women, this comprises removal of the male reproductive organs, creation of a neovagina and clitoris, and often implantation of breast prostheses. Studies have shown good sexual satisfaction after transition. However, long-term follow-up data on physical, mental and sexual functioning are lacking.
  
  
  OBJECTIVE
  To gather information on physical, mental, and sexual well-being, health-promoting behavior and satisfaction with gender-related body features of transsexual women who had undergone SRS.
  
  
  METHODS
  Fifty transsexual women who had undergone SRS >or=6 months earlier were recruited.
  
  
  METHODS
  Self-reported physical and mental health using the Dutch version of the Short-Form-36 (SF-36) Health Survey; sexual functioning using the Dutch version of the Female Sexual Function Index (FSFI). Satisfaction with gender-related bodily features as well as with perceived female appearance; importance of sex, relationship quality, necessity and advisability of gynecological exams, as well as health concerns and feelings of regret concerning transition were scored.
  
  
  RESULTS
  Compared with reference populations, transsexual women scored good on physical and mental level (SF-36). Gender-related bodily features were shown to be of high value. Appreciation of their appearance as perceived by others, as well as their own satisfaction with their self-image as women obtained a good score (8 and 9, respectively). However, sexual functioning as assessed through FSFI was suboptimal when compared with biological women, especially the sublevels concerning arousal, lubrication, and pain. Superior scores concerning sexual function were obtained in those transsexual women who were in a relationship and in heterosexuals.
  
  
  CONCLUSIONS
  Transsexual women function well on a physical, emotional, psychological and social level. With respect to sexuality, they suffer from specific difficulties, especially concerning arousal, lubrication, and pain.
authors.affiliation: Department of Gynaecology, University Hospital of Ghent, Ghent, Belgium. steven.weyers@ugent.be
authors.forename: Steven
authors.initials: S
authors.lastname: Weyers
authors.forename: Els
authors.initials: E
authors.lastname: Elaut
authors.forename: Petra
authors.initials: P
authors.lastname: De Sutter
authors.forename: Jan
authors.initials: J
authors.lastname: Gerris
authors.forename: Guy
authors.initials: G
authors.lastname: T'Sjoen
authors.forename: Gunter
authors.initials: G
authors.lastname: Heylens
authors.forename: Griet
authors.initials: G
authors.lastname: De Cuypere
authors.forename: Hans
authors.initials: H
authors.lastname: Verstraelen
mesh_terms: D000328:Adult; D001143:Arousal / Q000502:physiology; D001828:Body Image; D005260:Female; D005500:Follow-Up Studies; D005783:Gender Identity; D006304:Health Status; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D010146:Pain / Q000453:epidemiology; D010809:Physical Fitness; D012649:Self Concept; D012725:Sexual Behavior / Q000502:physiology*; D012938:Social Perception; D011795:Surveys and Questionnaires; D014189:Transsexualism / Q000453:epidemiology*