Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden.

<h4>Context</h4>The treatment for transsexualism is sex reassignment, including hormonal treatment and surgery aimed at making the person's body as congruent with the opposite sex as possible. There is a dearth of long term, follow-up studies after sex reassignment.<h4>Objecti...

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Autores principales:	Cecilia Dhejne, Paul Lichtenstein, Marcus Boman, Anna L V Johansson, Niklas Långström, Mikael Landén
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f4a9898afccd4c7a842fd60c3e90f37a
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spelling	oai:doaj.org-article:f4a9898afccd4c7a842fd60c3e90f37a2021-11-18T06:58:29ZLong-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden.1932-620310.1371/journal.pone.0016885https://doaj.org/article/f4a9898afccd4c7a842fd60c3e90f37a2011-02-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21364939/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Context</h4>The treatment for transsexualism is sex reassignment, including hormonal treatment and surgery aimed at making the person's body as congruent with the opposite sex as possible. There is a dearth of long term, follow-up studies after sex reassignment.<h4>Objective</h4>To estimate mortality, morbidity, and criminal rate after surgical sex reassignment of transsexual persons.<h4>Design</h4>A population-based matched cohort study.<h4>Setting</h4>Sweden, 1973-2003.<h4>Participants</h4>All 324 sex-reassigned persons (191 male-to-females, 133 female-to-males) in Sweden, 1973-2003. Random population controls (10:1) were matched by birth year and birth sex or reassigned (final) sex, respectively.<h4>Main outcome measures</h4>Hazard ratios (HR) with 95% confidence intervals (CI) for mortality and psychiatric morbidity were obtained with Cox regression models, which were adjusted for immigrant status and psychiatric morbidity prior to sex reassignment (adjusted HR [aHR]).<h4>Results</h4>The overall mortality for sex-reassigned persons was higher during follow-up (aHR 2.8; 95% CI 1.8-4.3) than for controls of the same birth sex, particularly death from suicide (aHR 19.1; 95% CI 5.8-62.9). Sex-reassigned persons also had an increased risk for suicide attempts (aHR 4.9; 95% CI 2.9-8.5) and psychiatric inpatient care (aHR 2.8; 95% CI 2.0-3.9). Comparisons with controls matched on reassigned sex yielded similar results. Female-to-males, but not male-to-females, had a higher risk for criminal convictions than their respective birth sex controls.<h4>Conclusions</h4>Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.Cecilia DhejnePaul LichtensteinMarcus BomanAnna L V JohanssonNiklas LångströmMikael LandénPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 2, p e16885 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Cecilia Dhejne Paul Lichtenstein Marcus Boman Anna L V Johansson Niklas Långström Mikael Landén Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden.
description	<h4>Context</h4>The treatment for transsexualism is sex reassignment, including hormonal treatment and surgery aimed at making the person's body as congruent with the opposite sex as possible. There is a dearth of long term, follow-up studies after sex reassignment.<h4>Objective</h4>To estimate mortality, morbidity, and criminal rate after surgical sex reassignment of transsexual persons.<h4>Design</h4>A population-based matched cohort study.<h4>Setting</h4>Sweden, 1973-2003.<h4>Participants</h4>All 324 sex-reassigned persons (191 male-to-females, 133 female-to-males) in Sweden, 1973-2003. Random population controls (10:1) were matched by birth year and birth sex or reassigned (final) sex, respectively.<h4>Main outcome measures</h4>Hazard ratios (HR) with 95% confidence intervals (CI) for mortality and psychiatric morbidity were obtained with Cox regression models, which were adjusted for immigrant status and psychiatric morbidity prior to sex reassignment (adjusted HR [aHR]).<h4>Results</h4>The overall mortality for sex-reassigned persons was higher during follow-up (aHR 2.8; 95% CI 1.8-4.3) than for controls of the same birth sex, particularly death from suicide (aHR 19.1; 95% CI 5.8-62.9). Sex-reassigned persons also had an increased risk for suicide attempts (aHR 4.9; 95% CI 2.9-8.5) and psychiatric inpatient care (aHR 2.8; 95% CI 2.0-3.9). Comparisons with controls matched on reassigned sex yielded similar results. Female-to-males, but not male-to-females, had a higher risk for criminal convictions than their respective birth sex controls.<h4>Conclusions</h4>Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.
format	article
author	Cecilia Dhejne Paul Lichtenstein Marcus Boman Anna L V Johansson Niklas Långström Mikael Landén
author_facet	Cecilia Dhejne Paul Lichtenstein Marcus Boman Anna L V Johansson Niklas Långström Mikael Landén
author_sort	Cecilia Dhejne
title	Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden.
title_short	Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden.
title_full	Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden.
title_fullStr	Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden.
title_full_unstemmed	Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden.
title_sort	long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in sweden.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/f4a9898afccd4c7a842fd60c3e90f37a
work_keys_str_mv	AT ceciliadhejne longtermfollowupoftranssexualpersonsundergoingsexreassignmentsurgerycohortstudyinsweden AT paullichtenstein longtermfollowupoftranssexualpersonsundergoingsexreassignmentsurgerycohortstudyinsweden AT marcusboman longtermfollowupoftranssexualpersonsundergoingsexreassignmentsurgerycohortstudyinsweden AT annalvjohansson longtermfollowupoftranssexualpersonsundergoingsexreassignmentsurgerycohortstudyinsweden AT niklaslangstrom longtermfollowupoftranssexualpersonsundergoingsexreassignmentsurgerycohortstudyinsweden AT mikaellanden longtermfollowupoftranssexualpersonsundergoingsexreassignmentsurgerycohortstudyinsweden
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Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden.

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