Sexual functioning in transsexuals following hormone therapy and genital surgery: a review.
BACKGROUND
Sexual function following genital sexual reassignment surgery (SRS) is an important outcome for many transsexuals, affecting the choice of surgical technique, satisfaction with surgery, and quality of life. However, compared to other outcome measures, little clinical and research attention has been given to sexual functioning following SRS.


OBJECTIVE
To discuss the potential impact of cross-sex hormone therapy and SRS on sexual function and to summarize the published empirical research on postsurgical sexual functioning in male-to-female (MtF) and female-to-male (FtM) transsexuals.


METHODS
Cross-sex hormone therapy and SRS techniques are outlined, the potential roles of cross-sex hormone therapy and SRS on sexual function are discussed, and peer-reviewed literature published in English on postoperative sexual functioning in MtF and FtM transsexuals is reviewed.


METHODS
Sexual desire, sexual arousal, and ability to achieve orgasm following SRS.


RESULTS
Contrary to early views, transsexualism does not appear to be associated with a hyposexual condition. In MtF transsexuals, rates of hypoactive sexual desire disorder (HSDD) are similar to those found in the general female population. In FtM transsexuals, sexual desire appears unequivocally to increase following SRS. Studies with MtF transsexuals have revealed not only vasocongestion, but also the secretion of fluid during sexual arousal. Research on sexual arousal in FtM transsexuals is sorely lacking, but at least one study indicates increased arousal following SRS. The most substantial literature on sexual functioning in postoperative transsexuals pertains to orgasm, with most reports indicating moderate to high rates of orgasmic functioning in both MtF and FtM transsexuals.


CONCLUSIONS
Based on the available literature, transsexuals appear to have adequate sexual functioning and/or high rates of sexual satisfaction following SRS. Further research is required to understand fully the effects of varying types and dosages of cross-sex hormone therapies and particular SRS techniques on sexual functioning.
Klein
Carolin
C
University of British Columbia-Department of Psychology, 2136 West Mall, Vancouver V6T 1Z4, Canada. carolinklein@psych.ubc.ca
Gorzalka
Boris B
BB
D005260:Female; D012739:Gonadal Steroid Hormones / Q000502:physiology / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008418:Masturbation / Q000503:physiopathology; D009948:Orgasm / Q000502:physiology; D012725:Sexual Behavior / Q000502:physiology*; D019529:Sexuality / Q000502:physiology; D014189:Transsexualism / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy
D012739:Gonadal Steroid Hormones