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Editors:
Friedemann Pfäfflin,
 Ulm University, Germany
 
Walter O. Bockting,
 University of Minnesota, USA
 
Eli Coleman,
 University of Minnesota, USA
 
Richard Ekins,
 University of Ulster at Coleraine, UK
 
Dave King,
 University of Liverpool, UK

Managing Editor:
Noelle N Gray,
 University of Minnesota, USA

Editorial Assistant:
Erin Pellett,
 University of Minnesota, USA

Editorial Board

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Published by
Symposion Publishing
  
ISSN 1434-4599

  
XVI Harry Benjamin International Gender Dysphoria Association Symposium
17 - 21 August 1999, London

Reflections on "Transsexualism and Sex Reassignment" 1969 -1999

Total Pharmacological Suppression of Androgens in Male-to-Female Transsexuals do not Interfere With Normal Erection

Bettocchi, C.,V. Zizzi, I. Veneziano, V. Ricapito, G. De Ceglie, M. Battaglia, F.P. Selvaggi

Cattedra di Urologia, University of Bari – Italy.

INTRODUCTION: Different authors confirmed that primary effect of androgen in male sexuality is on libido, ejaculation, and "centrally" controlled erections. The aim of the study was to determine whether a total androgen ablation longer than 2 years should cause erectile dysfunction in male-to-female transsexuals.

MATERIAL AND METHODS: During the period December 1996-December 1998, 14 male-to-female transsexuals were visited in our Department before the vaginoplasty operation. All of them were in treatment with a total androgen ablation and oestrogen for a period of at least 2 years (mean 55 months – range 29-96) in order to facilitate the development of female secondary sex characteristics. We performed a complete evaluation of their erectile function, doing an accurate medical history, physical examination, hormonal profile (LH-FSH-Testosterone-DHT-PRL), color Doppler US with intracavernous injection of 20 to 40 µg PGE1 and NPT test.

RESULTS: Only three of the 14 pts referred had erectile problems. The hormone profile showed a low testosterone in all of them, with normal LH and FSH. Dynamic color Doppler US showed a good clinical response in 12 patients and veno-occlusive dysfunction in the others probably secondary to adrenergic tone due to exam anxiety. The NPT test, performed over one night in the hospital, showed presence of rigid events in 11 of them.

CONCLUSION: A long period of complete androgen ablation should cause a reduction of testosterone level and libido but does not interfere with the possibility of these patients to achieve a valid rigid erection.