Arieff, 1973
Dept. of Neurology and Psychology, Passavant Memorial Hospital, Northwestern University Medical School, Chicago, IL., USA

This congress contribution of a neurologist and psychologist shows little. Important basic information, like for example type of treatment and similar, are not reported. On the other side, the reasons why patients did not receive desired treatment are mentioned extensively.

• Sample
• Evaluation Fields and Criteria
• Results
• Indication Recommendations
• Remarks

Evaluation Fields and Criteria
The pre-surgical situation and development of the patients was described by the age at the time of manifestation of the gender identity symptoms, criminal convictions, anti-social behavior, drug abuse, sexual experience, work situation, psychiatric history, acceptance by the family, anatomical characteristics, appearance and role behavior of the other gender. To characterize the post-surgical situation, indication to the social adaptation, to the workplace, marital status, sexual orientation and psychiatric illnesses were made that were not more closely specified.

Results
Results are not represented separated by gender. Post-surgically nine of the treated were better adapted socially, two had a better workplace. Four females and one male were married. Four had heterosexual relations, among them one of the married. Five patients had bettered noticeably in regard to the psychiatric symptoms; one patient with psychopathic characteristics had worsened. In accordance to the evaluation done in retrospect by the author, this patient should not have been operated. Finally, one patient was at times in psychiatric treatment.

Indication Recommendations
These are not defined but they can be deduced by the description of the 22 who desired surgery and were denied. They were, on average, older (31-35 years) than the operated, had less education, had bi-sexual, transsexual or transvestite behavior, had married and had had children, were socially unstable or had no clear future perspectives. Sixteen of the 22 were given the diagnosis psychosis. Other diagnoses were immaturity, low intelligence, chronic alcoholism, sociopathy, and so on.

Remarks
This follow-up study is an example for inaccuracy and the arbitrary selection of the transmitted data. One does not learn at all what treatments were done. It is said about the small sample of males (n=4) "some have had mastectomies and hysterectomies." (p. 240); the examination time for which a mean of age is indicated does not allow any conclusions as to the age of patients when operated. Remarks such as "Four had relations with the opposite sex. In a few of the cases, the activity was rectal and oral" (p. 241) and "One patient's wife was agreeable" (p. 243) allow suppositions about the attitude of the author but do not inform about the treatments and their results. At least one learns that the cost of this type of psychiatric evaluation on which this publication was presumably based was 250 US dollars and the flexibly handled operation cost was a mean of 2500 US dollars with a stationary handling mean of seven days.