title: Long-Term Follow-Up of Individuals Undergoing Sex-Reassignment Surgery: Somatic Morbidity and Cause of Death.
abstract: BACKGROUND
  Studies of mortality and somatic well-being after sex-reassignment surgery (SRS) of transsexual individuals are equivocal. Accordingly, the present study investigated mortality and somatic morbidity using a sample of transsexual individuals who comprised 98% (n = 104) of all surgically reassigned transsexual individuals in Denmark.
  
  
  OBJECTIVE
  To investigate somatic morbidity before and after SRS and cause of death and its relation to somatic morbidity after SRS in Danish individuals who underwent SRS from 1978 through 2010.
  
  
  METHODS
  Somatic morbidity and mortality in 104 sex-reassigned individuals were identified retrospectively by data from the Danish National Health Register and the Cause of Death Register.
  
  
  METHODS
  Somatic morbidity and cause of death.
  
  
  RESULTS
  Overall, 19.2% of the sample were registered with somatic morbidity before SRS and 23.1% after SRS (P = not significant). In total, 8.6% had somatic morbidity before and after SRS. The most common diagnostic category was cardiovascular disease, affecting 18 individuals, 9 before and 14 after SRS, and 5 of those 14 who were affected after SRS had cardiovascular disease before and after SRS. Ten individuals died after SRS at an average age of 53.5 ± 7.9 years (male to female) and 53.5 ± 7.3 years (female to male).
  
  
  CONCLUSIONS
  Of 98% of all Danish transsexuals who officially underwent SRS from 1978 through 2010, one in three had somatic morbidity and approximately 1 in 10 had died. No significant differences in somatic morbidity or mortality were found between male-to-female and female-to-male individuals. Despite the young average age at death and the relatively larger number of individuals with somatic morbidity, the present study design does not allow for determination of casual relations between, for example, specific types of hormonal or surgical treatment received and somatic morbidity and mortality.
authors.affiliation: Department of Sexology, University Hospital of Copenhagen, Copenhagen, Denmark. Electronic address: rikke.kildevaeld@regionh.dk.
authors.forename: Rikke Kildevæld
authors.initials: RK
authors.lastname: Simonsen
authors.affiliation: Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Gert Martin
authors.initials: GM
authors.lastname: Hald
authors.affiliation: Sexological Clinic, Psychiatric Center Copenhagen, Copenhagen, Denmark.
authors.forename: Ellids
authors.initials: E
authors.lastname: Kristensen
authors.affiliation: Sexological Clinic, Psychiatric Center Copenhagen, Copenhagen, Denmark.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Giraldi
keywords: Follow-Up; Gender Identity Disorder; Sex-Reassignment Surgery; Somatic Morbidity; Transsexualism