XVII Harry Benjamin International Gender Dysphoria Association Symposium
31 October - 4 November 2001, Galveston, Texas, U.S.A.

Sex Reassignment Surgery Without a One Year Real-Life Experience: Still No Regrets

LAWRENCE, ANNE U.S.A.
E-mail: alawrence@mindspring.com

Background: It is well known in the transgender community that some male-to-female (MtF) transsexuals undergo sex reassignment surgery (SRS) without first completing a one year real-life experience (RLE). Since this practice deviates from the Standards of Care, therapists and surgeons may be unwilling to report outcomes in such cases. A 1997 pilot study by the author reported on 18 MtF transsexuals who had undergone SRS without a one year RLE. None of these individuals expressed regrets. The current study reexamined this issue, and asked additional questions about the perceived benefits and disadvantages of SRS without a full year of RLE.

Methods: Participants were again recruited from a solicitation on the author’s Internet site. They were asked to complete and return an e-mail questionnaire consisting of 19 items concerning their transition and the extent of their satisfaction with the RLE and subsequent SRS.

Results: 13 persons submitted responses that conformed to the inclusion criterion, a RLE of 10 months or less. None of these individuals had participated in the 1997 study. The respondents had undergone SRS between May 1992 and August 2000. Their median time from date of SRS to date of survey completion was 12 months (range, 3-87 months). They reported a median RLE of 6 months (range, 0-9 months). Their median age was 44 years (range, 27-57 years). They were highly educated (6 with post-graduate degrees, 4 with a college degree only, 3 with some college only). 11 of the 13 reported that their therapists had approved them for SRS with full knowledge that they had not undergone a one year RLE. None of the 13 respondents regretted SRS, and only one said she wished her RLE had been longer. The respondents reported a number of practical and subjective benefits from having a short RLE, or none at all. These included: sustaining needed employment, pursuing significant relationships and avocational interests, avoiding difficulties with authorities, and achieving personal comfort.

Conclusions: Some MtF transsexuals continue to undergo SRS without a one year RLE, with the full knowledge and support of their therapists. These individuals are typically middle-aged and highly educated, although this may reflect sampling bias. Selected MtF transsexuals can undergo therapist-supported SRS without a one year RLE without expressing regret. These results do not support the SOC requirement of a one year RLE as an absolute eligibility criterion for SRS.