Steiner, 1976
Gender Identity Clinic, Clarke Institute of Psychiatry, University of Toronto, Canada

The article gives a limited overview about other follow-up studies and reports about a small sample from Toronto with an evaluation oriented on Hastings (1974) evaluation of the post-surgical situation

• Sample
• Evaluation Fields and Criteria
• Results
• Follow-up Studies Mentioned
• Authors' Conclusion
• Indication Recommendations
• Remarks

Evaluation Fields and Criteria
The patients were evaluated by the criteria described by Hastings (1974) regarding the social, emotional, economic and sexual situation on a four-level scale (excellent, good, fair and unsatisfactory), wherein pre-surgical comparison data is missing.

Results
Females: In social adjustment three females each were evaluated as excellent, resp., good and one as fair. The emotional state was evaluated for two females as being excellent and for five as good. The economic situation was evaluated for three females as excellent, for two each as good, resp., unsatisfactory. The sexual aspect was in the evaluation good for five females and for two females fair.
Males: The social, economic and mental situation was classified for three males as excellent, for one good, resp., fair. In the sexual aspect the evaluation was good for three males and for two males fair.

Follow-up Studies Mentioned
Benjamin, 1966; Hamburger et al., 1953; Hastings, 1974; Hoenig et al, 1978a; Kando, 1973; Money, 1971; Pauly, 1965, 1968; Randell, 1969

Authors' Conclusion
Summarizing, the author cites Hoenig (1974) to concur with him: "The existence of a presurgical long-term observation period would help to exclude the diagnostical categories that do not benefit from the surgical procedures. The same principle, in the form of a long-term observation, is the only method to erudite an answer to the question if surgical sex reassignment is the best treatment for transsexual patients in every case" (p. 845).

Indication Recommendations
The author demands pre-surgically "an adequate and complete examination and observation of the patient over a longer period of time lasting at least one to two years" (p. 842). About the reasons and the purpose of this observation or the treatment connected to it, indications are not made.

Remarks
What is called a follow-up study in the article limits itself to two tables with compiled estimated data. Even minimal sociographic data about the patient population and about the examination plan and realization are missing.