Surgical gender reassignment for male to
female transsexual people
Best L, Stein K.
Surgical gender reassignment for male to female transsexual people.
Southampton: Wessex Institute for Health Research and Development, 1998:25.
Abstract [Full Text] [PDF]
Abstract
This is a publication undertaken by a
member of INAHTA. For further information please contact the agency using the
contact details in the Correspondence Address field.
Author's objective
To provide an overview of the effectiveness
and cost-effectiveness of surgical gender reassignment for male to female
transsexuals.
Type of intervention
Surgery
Study design
Review
Sources searched
The electronic databases MEDLINE, HealthStar,
Embase, the Cochrane Library, Social Science Citation Index, PsycLit, the
National Research Register and GEARS were searched.
Results
There is no comparable alternative to gender
reassignment surgery in those who are eligible for surgery. Individuals who
are refused NHS treatment may approach private clinics, both in the UK and
abroad. The prevalence of transsexualism has not been studied in this country
in recent years. European studies suggest that there may be 150 male
transsexual people in the South and West region, and we may expect five
requests for surgical gender reassignment each year. Current evidence consists
of one prospective controlled study, numerous case series, and one
cross-sectional study. Most studies about the effectiveness of surgical gender
reassignment have not collected data prospectively and are hampered by losses
to follow up and lack of validated outcome measures. It is evident that a
number of male to female transsexual people experience a successful outcome
following surgery in terms of subjective well-being, cosmetic appearance and
sexual function. Some patients have reported postoperative complications,
dissatisfaction and regrets.
Was any cost information reported?
Surgical gender reassignment surgery costs in
the region of 9,600 GBP (ECR prices). Following successful surgery the need
for psychiatric and hormonal treatment may be reduced, thereby resulting in
savings of up to 950 GBP per patient per year.
Authors' conclusions
It is clear that a small number of people may
experience important benefits from this technology. However, the potential
hazards of treatment are considerable and more rigorous research is required
into the long term risks and benefits to support case selection and justify
service development. Where surgery is performed it should be restricted to
specialist centres with proven technical expertise and which have clear
protocols for patient selection and good clinical audit in place. Pending
improvements to the evidence base in this area, the Committee noted the value
of guidelines such as those promulgated by the Harry Benjamin Gender Dsyphoria
Association in identifying minimum standards of care for people applying for
surgery.
Citation: Published on the Internet by
University of York
