Prior to considering surgical reassignment,
the key issue for the surgeon is to establish beyond reasonable doubt that
the gender dysphoria or transsexual feeling is genuine and that surgical
reassignment will be beneficial. For this he will need the expertise of a
reputable behavioural scientist. To determine whether the patient is
physically fit for surgery, the surgeon may lean on the expertise of an
endocrinologist with substantial personal experience in the field of
hormonal treatment of transsexuals.
Sex reassignment for M-->F transsexuals
may be completed in one operation, leading to acceptable cosmetic and
functional results, provided the surgery and postoperative treatment are
performed with a high degree of expertise. Present generation operative
techniques for phalloplasty in F-->M transsexuals still do not meet all
requirements. The term 'one-stage phalloplasty' is deceiving. Genital
reassignment surgery in F-->M transsexuals can seldom be achieved in one
stage. Prior to any form of this kind of surgery, this should be made clear
to the patient. F-->M and M-->F transsexuals will become irreversibly
infertile by the orchiectomy and the oophoro-hysterectomy usually performed
on them.
Diagnosis of, and counselling and treatment
for, gender dysphoria should be restricted to reputable gender teams. These
teams should exchange information.
Citation:
Med Sci Law 1995 Jan;35(1):17-24 an article
published on the Internet by PubMed <http://www.ncbi.nlm.nih.gov/>
