Quality of life after gender reassignment surgery in transwomen
Keywords:Gender dysphoria, Gender reassignment surgery, Male to female, Transwomen, QoL
Background: Gender dysphoria is a condition in which there is discrepancy between a person's gender identity and that person's sex assigned at birth. Gender reassignment surgery (GRS) has an important role in alleviating the distress caused by gender dysphoria and it is medically necessary. The literature on quality of life (QoL) of transgenders post-GRS is limited in India.
Methods: This is a prospective study on transgender women who volunteered to undergo male to female (MtF) GRS from March 2015 to August 2017. The demographic details and the surgical complications were registered. The Quality of life using the WHOQOL-BREF questionnaire was measured both before and a year after the surgery. The data were compared and presented.
Results: A total of 62 GRS were performed during the study period. In that, 43 patients are literate (69.35%) and only 31.93% are employed in a socially respectable position. Our study shows significant improvement in physical, psychological and social health domains after the Surgery. Highest improvement was observed in the psychological health domain. There were no major complications observed in our study group.
Conclusions: The surgical management improved the QOL in the first three domains of WHOQOL-BREF instrument namely physical health, psychological health and social relationship. Among these three domains, there is a significant improvement in psychological health. Hence, GRS has an important role in relieving the psychological distress caused by gender dysphoria and significantly improves the quality of life postoperatively.
Care for the health of transsexuals, transgender and gender non confirming people, the world professional association for transgender healt. 7th version. Available at: https://www.wpath.org/ media/cms/Documents/SOC%20v7/Standards%20of%20Care_V7%20Full%20Book_English.pdf. Accessed on 25July 2020.
BMJ Best Practice reports. Available at: http://bestpractice.bmj.com/bestpractice/monograph/992/basics/epidemiology.html. 2014. Accessed on 25July 2020.
Sawant NS. Transgender: status in India. Ann Indian Psychiatry 2017;1:59-61.
Radhakrishnan KS. In the supreme court of India Civil original jurisdiction Writ petition (Civil) No. 400 of 2012 National legal services authority. Judgment 2013. Available at: http://www.prsindia. org/uploads/mediaTransgender/Transgender%20rights%20case%20(NALSA%20vs.%20UoI)pdf. Accessed on 25July 2020.
Valashany BT, Janghorbani M. Quality of life of men and women with gender identity disorder. Health Qual Life Outcomes. 2018; 16:167.
Davey A, Bouman WP, Arcelus J, Meyer C. Social support and psychological well-being in gender dysphoria: a comparison of patients with matched controls. J Sex Med. 2014;11:2976-85.
Kuhn A, Bodmer C, Stadlmayr W, Nuñez DG. Quality of life 15 years after sex reassignment surgery for transsexualism. Fertil Steril. 2009;92: 1685-9 .
Newfield E, Hart S, Dibble S, Kohler L. Female-to-male transgender quality of life. Qual Life Res. 2006;15:1447-57.
Transgender health emergency rooms and hospitals. Available at: https://www.national geographic.com/ news/2018/03/transgender-health-emergency-rooms-training-hospitals-science/. Accessed on 25July 2020.
Subbaraj S, Srinivasan, Nivethaa. Gender reassignment surgery: male to female, a short-term analysis of post-operative outcome. Int Surg J. 2017; 4:3288-91.
McGregor IA. Fundamental techniques of plastic surgery and their surgical applications. 8th Ed. Edinburgh: Churchill Livingstone; 1989:39-63.
Karim RB, Hage JJ, Bouman FG, De Ruyter R, Van Kesteren PJM. Refinements of pre, intra, and post-operative care to prevent complications of vaginoplasty in male transsexuals. Ann Plast Surg. 1995;35:279.
Gupta R, Murarka A. Indian J Plast Surg. 2009;42 (2):226-33.
Study on wellbeing of trasgenders in Chennai. Availabe at: https://counselingchennai.com/wp-content/uploads/2019/01/abstract_corrected_a_study_on_general_wellbeing_of_male_to_female_transgenders_living_in_chennai.22205801.pdf. Accessed on 25 July 2020.
Harper A. WHOQOL Bref- World health Organization. Available at: https://www.who.int/ mental_health/media/en/76.pdf. Accessed on 25 July 2020.
Lakshmipathy S, Thenmozhi S. Quality of life: A Study of Transgenders. International Journal of Indian Psychology. 2019;7(2),571-5.
Rehman J, Lazer S, Benet AE, Schaefer LC, Melman A. The reported sex and surgery satisfactions of 28 postoperative male-to-female transsexual patients. Archives of sexual behavior. 1999;28: 7-89.
Tsoi WF. Follow-up study of transsexuals after sex-reassignment surgery. Singapore Med J. 1993;34: 515-7.
Lindqvist EK, Sigurjonsson H, Möllermark C, Rinder J, Farnebo F, Lundgren TK. Quality of life improves early after gender reassignment surgery in transgender women. Eur J Plast Surg. 2017;40(3): 223-6.