Importance of Psychological Care
From my dual perspective as an internist in private practice and a transsexual woman, I wish to comment on the study, which does not only deal with the consequences of gender reassignment surgery but also touches on the problems of medical care for transsexual persons in general (1). I was pleased to see an interpretation that moves away from the perspective of sexual pathology. Unfortunately, transsexuality still ranges among the mental disorders. Many of those affected would wish for medical care beyond any sex/gender-specific perspective and one of sexual pathology. I was edified to read about the study of satisfaction considering various aspects, from esthetics to function, the ability to have an orgasm to social aspects. My personal interpretation of the low response rate of the questionnaires is that very satisfied persons who have arrived in their role have less need to communicate this by means of questionnaires.
I agree with the authors’ opinion that experiencing orgasms more intensely is a result of a more harmonious body image.
My personal assumption relating to the satisfaction after gender reassignment surgery is also that this depends on the individual expectations of the effects of such surgery. Some people conflate the operation with their hopes for a solution to all their personal and social problems. Others hope that they will achieve their desired gender role by dint of the surgical procedure itself and without further active input from themselves. In my view, such an overload of expectations and hopes only leads to an increased risk for dissatisfaction if expectations are not met. I therefore believe that effective and professional psychological care remains of great importance, even though many transsexual persons reject compulsory psychotherapy as a prerequisite before they can access medical measures.
Dr. med. Maria Kohl
|1.||Hess J, Rossi Neto R, Panic L, Rübben H, Senf W: Satisfaction with male-to-female gender reassignment surgery—results of a retrospective analysis. Dtsch Arztebl Int 2014; 111: 795–801 VOLLTEXT|