Authors' objectives:

To provide an overview of the effectiveness and cost-effectiveness of surgical gender reassignment for male to female transsexuals.

Authors' results and conclusions: 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.

Authors' recommendations: 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.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.wihrd.soton.ac.uk

Year Published: 1998

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: Wessex Institute for Health Research and Development

Contact Address: Pauline King. Wessex Institute for Health Research and Development, Boldrewood Medical School, Bassett Crescent East, Highfield, Southampton. SO16 7PX Tel. +44 1703 595661 Fax +44 1703 595662

Copyright: Wessex Institute for Health Research and Development (WIHRD)