| IJT Electronic Books |
| Friedemann
Pfäfflin, Astrid Junge Sex Reassignment. Thirty Years of International Follow-up Studies After Sex Reassignment Surgery: A Comprehensive Review, 1961-1991(Translated from German into American English by Roberta B. Jacobson and Alf B. Meier) |
| Content Introduction Methods Follow-up Studies (1961-1991) Reviews Table of Overview Results and Discussion References IJT Subscribers Info Published by |
Historic Papers 
Chapter 3: Follow-up studies in chronological order
Benjamin, 1967
Private practice, New York, NY, USA
Apart from the larger sample, this follow-up study is identical with the previous publications of the author (Benjamin 1964a, b, c, 1966). Because of this, only the sample size, type of treatment, global ratings and indication recommendations are reported.
| Sample | Females (MFT) | Males (FMT) |
| Total group* | (242) | (28) |
| Operated | 76 | 20 |
| Followed-up | 73 | |
| *The author talks about a total group of 368 transvestites whom he had seen during the previous 14 years, among them 270 transsexuals. | ||
| Type of Treatment* | ||
| Hormones | 76 | Hormones 28 |
| Breast reduction 9 | ||
| Penectomy/orchidectomy | 76 | Hysterectomy/ovarectomy 11 |
| Vaginoplasty | 70 | Phalloplasty 2 |
| *The patients underwent surgery in Denmark, The Netherlands, Sweden, Mexico, Morocco and the USA (there mainly in California and one patient in the Johns Hopkins Hospital in Baltimore). The figures given for males in the text (p. 125) are inconsistent: Of 28 males, 16 were not operated and 20 were operated. Of the latter, 11 had the womb removed, nine had breast reductions and seven had both surgeries. Among the females, five had somewhat successfully attempted auto-castration. | ||
| Follow-up Time Since Surgery | ||
| Range | at least 3 months | |
Results
Females: Overall the results for 62
were rated as being good or satisfactory. With nine, it
was rated as doubtful and with two it was rated as
unsatisfactory.
Males: With the exception of one male who was
rated as doubtful, the results for all others were
globally rated as good or satisfactory.
Indication Recommendations
"The indication for the operation is to be made
with the greatest caution. The request for surgery from
the patient, no matter how impressively presented, must
not be based on a passing erotic mood of an immature
personality, but must be the permanent, deep conviction
of a non-psychotic, reasonably intelligent and
responsible person. Therefore, several months of
observation are advisable, preferably under estrogen
treatment, which takes the edge off the emotional
intensity...Psychiatric evaluation, if at all possible,
should precede the operation...Most important for the
indication for a sex reassignment operation is the belief
that a successful 'woman' can result and that there is no
other way to help the patient toward an emotionally
healthier and happier future" (pp. 117-118).
Follow-up Studies Mentioned
Benjamin, 1964a, 1966; Hamburger et al., 1953; Hertz
et al., 1961
Remarks
The author emphasizes, contrary to his previous
publications, that he participated in the treatment but
left the indication for surgery to a psychiatrist.
"Many patients, unfortunately, did not wait for any
psychiatric consultation, or for anybody's consent, and
found their own surgeon, usually abroad" (p. 118).
This statement shows how little the quite flexibly
formulated indication recommendations were/could be
enforced
