The majority of patients who undergo male to female sex-change surgery are happy with the results, despite the fact that complications are common, according to a study of over 200 patients in the September issue of the urology journal BJU International.

A research team from the Departments of Urology and Psychiatry at University Hospitals of Leicester NHS Trust, UK, explored the initial experiences of 222 patients who had undergone surgery and 70 who took part in detailed follow-ups.

They found that 88 per cent of patients were happy with their surgery at their first post-operative clinic visit, seven per cent were unhappy and five per cent made no comment.

All the patients studied had had their penis surgically removed, their urethra repositioned and female labia constructed. 93 per cent had a clitoris constructed using a section of the glans of their penis and 91 per cent had a skin-lined vagina.

“The outcome of this complex surgery depends on a number of factors” says lead author, urology registrar Jonathan C Goddard.

“These include the technical experience of the surgeon, the amount and quality of tissue that each patient has available for reconstruction and, most importantly, the realistic expectations of the patients themselves.

“One of the biggest problems with research of this nature is that many patients are difficult to contact. Having gone through a two-year real-life test before extensive surgery, which can include breast as well as genital construction, many want to start a new life and compartmentalise their past. This can include moving to a new area.”

Despite this, the research team managed to contact 70 of the patients who had undergone surgery at the hospital between 1994 and 2004.

They ranged from 19 to 76 years of age, with an average age of 43. Most had had surgery about three years before. 91 per cent had had a clitoris created and 89 per cent had had a vagina created.

The researchers found that:

• 23 per cent of the patients had, or were having, regular intercourse and 61 per cent were happy with the depth of their vagina.
• 98 per cent had a sensitive clitoris and 48 per cent were able to achieve orgasm. 14 per cent were hypersensitive but none had elected to have their clitoris removed.
• 29 per cent were troubled by vaginal hair growth, six per cent had had a vaginal prolapse and three per cent had vaginal necrosis (tissue death).
• 27 per cent reported urinary problems and the majority of these needed revision surgery.

“Despite these problems, which were mainly minor and easily corrected by secondary surgery, 76 per cent of the patients who provided detailed feedback were happy with the cosmetic result of their surgery and 80 per cent said the surgery had met their expectations” concludes Jonathan C Goddard.

Article: Feminizing genitoplasty in adult transsexuals: early and long-term surgical results. Goddard et al. BJU International. 100, pages 607 to 613, September 2007.