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

Reflections on "Transsexualism and Sex Reassignment" 1969 -1999

The Reported Sexual and Surgery Satisfactions of 27 Postoperative Male-to-Female Transsexual Patients

Schaefer, Leah C., Ed.D.¹, Lazer, Simcha, M.D.², Wheeler, C. Christine, Ph.D.³, Melman, Arnold, M.D.⁴

Data were collected on twenty-seven M-F transsexual patients, who were operated on in New York City by Arnold Melman, M.D. between the years of 1980 and 1994. A questionnaire, developed by the authors, served as the source for the data and was further supplemented by personal interviews with eleven of the patients to obtain and to clarify additional information.

The physical and functional results of the surgery were judged to be good (and even very good), with only a few patients requiring additional corrective surgery. General satisfaction was expressed over the quality of cosmetic results (normal appearing genitalia and reported ability to experience orgasm). Most patients were able to return to their jobs and to live a more workable social life.

The aim of this investigation was to accumulate first-hand information about the following:

1. the physiological and psychological functioning of operated transsexual patients, specifically in how both areas of functioning are perceived in correlation with individual expectations;
2. physiological aspects of the interrelationship between genital anatomy and sexual function;
3. the relationship between sexual adjustment and surgical results; and
4. how these patients perceived sexual satisfaction, what constituted personal sexual satisfaction, and for giving pleasure to a partner.

However, one significant outcome of the questionnaire pointed to the importance of proper and sufficient preparation of patients for surgery and, most especially, to the need for additional post-operative psychotherapy. This was particularly evident in that although none of the patients had any doubts or regrets about having had the surgery, most of them were, to some degree, disappointed because of the difficulties they continued to experience post-operatively in adjusting satisfactorily as women, both in their relationships with men in general and in living their lives as women. The findings of this study make a strong case for making a change in the Harry Benjamin Standards of Care to include a period of post-operative psychotherapy treatment that would assist these patients to live their lives more realistically and more fully as females, which they believe is their true inner gender.

Foodnotes
¹ 285 Riverside Drive, New York, New York 10025 USA
² Department of Obstetrics and Gynecology, Soroka Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel
³ 310 East 46^th Street, Suite 12-H, New York, New York 10017 USA
⁴ Department of Urology, Montefiore Medical Center/Albert Einstein College of Medicine, 210^th Street, Bronx, New York 10467 USA