OPERATIVE SEX-CHANGE IN TRANSSEXUALS - A INTERDISCIPLINARY APPROACH

From the introduction of the law on recognition of transsexuals (TSG) in 1980, over 1400 decisions were made by German regional district jud ges up to 1990. In over 90% of the cases the desired gender was accept ed and attested officially. In the near future, a growing number of re quests has to be expected. Generally, transsexual patients desire surg ery to achieve a complete sex change. Since the foundation of an inter disciplinary gender dysphoria identity committee at our institution in 1989, we have developed criteria on indications, operative techniques and follow-up, which would overtax a urology department, but which ca n be managed by an interdisciplinary team. Operative techniques may be regarded as well standardized in male-to-female transsexuals and may be performed by the urologist alone; in female-to-male transsexuals se x transformation remains complex interdisciplinary challenge to urolog ists and plastic surgeons, mainly due to urethral complications. Conti nuous psychiatric guidance and endocrinological monitoring of the pati ents facilitates indications for surgery and perioperative management.