Quality of life and sexual health after sex reassignment surgery in transsexual men.

Introduction: Although sexual health after genital surgery is an important outcome factor for many transsexual persons, little attention has been attributed to this subject.

Aims: To provide data on quality of life and sexual health after sex reassignment surgery (SRS) in transsexual men.

Methods: A single-center, cross-sectional study in 49 transsexual men (mean age 37 years) after long-term testosterone therapy and on average 8 years after SRS. Ninety-four percent of the participants had phalloplasty.

Main Outcome Measures: Self-reported physical and mental health using the Dutch version of the Short Form-36 Health Survey; sexual functioning before and after SRS using a newly constructed specific questionnaire.

Results: Compared with a Dutch reference population of community-dwelling men, transsexual men scored well on self-perceived physical and mental health. The majority reported having been sexually active before hormone treatment, with more than a quarter having been vaginally penetrated frequently before starting hormone therapy. There was a tendency toward less vaginal involvement during hormone therapy and before SRS. Most participants reported an increase in frequency of masturbation, sexual arousal, and ability to achieve orgasm after testosterone treatment and SRS. Almost all participants were able to achieve orgasm during masturbation and sexual intercourse, and the majority reported a change in orgasmic feelings toward a more powerful and shorter orgasm. Surgical satisfaction was high, despite a relatively high complication rate.

Conclusion: Results of the current study indicate transsexual men generally have a good quality of life and experience satisfactory sexual function after SRS.