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Several aspects of the quality of life after sex reassignment surgery in 32 transsexuals of both sexes (22 men, 10 women) were examined. The Belgrade Team for Gender Identity Disorders designed a standardized questionnaire for this purpose. The follow-up period after operation was from 6 months to 4 years, and four aspects of the quality of life were examined: attitude towards the patients' own body, relationships with other people, sexual activity, and occupational functioning. In most transsexuals, the quality of life was improved after surgery inasmuch as these four aspects are concerned. Only a few transsexuals were not satisfied with their life after surgery.
KEY WORDS: transsexualism; sex reassignment; follow-up; quality of life.
INTRODUCTION
Numerous articles on the outcome of sex reassignment surgery have been published in several countries (Benjamin, 1967; Blanchard et aL, 1987; Fahrner et al., 1987; Green and Money, 1969; Junge, 1987; Kuiper and Cohen-Kettenis, 1988; Lief and Hubschman, 1993; Lindemalm et al., 1986; Lundstrom, 1981; Mate-Kole et at, 1990; Pauly, 1968, 1981; Tsoi, 1990; Green and Fleming, 1991). These studies and reports focused on different aspects of the operated patients' lives.
Abramowitz (1986) reported results several follow-up studies. A selfreport instrument and a clinician-administered rating scale were used. The outcome of sex-reassignment surgery was better in terms of interpersonal adjustment than in terms of any other parameters. For example, changes in the socioeconomic status after the operation were found.
Ross and Need (1989) studied several bodily aspects and social and psychological functioning of transsexuals after sex reassignment surgery using a "Standardized Psychosocial Rating Format" (Hunt and Hampson, 1980). Social functioning of transsexuals improved and many of these patients displayed less psychopathology after sex reassignment surgery. They concluded that psychopathology in transsexuals was a consequence of transsexualism itself.
Lief and Hubschman (1993) examined a relationship of orgasm to sexual and general satisfaction in transsexuals after sex reassignment surgery, and found that orgasmic capacity decreased in male-to-female patients and increased in female-to-male patients. Despite the decrease in the ability to experience orgasm in male-to-female patients, satisfaction with the quality of sexual activity and general satisfaction with the results of surgery were high in both groups of patients.
Results of the reported follow-up and outcome studies of sex reassignment surgery depend on several factors:...