Surgical therapy in transsexual patients: a multi-disciplinary approach

A transsexual patient has the constant and persistent conviction that he or she belongs to the opposite sex, thus creating a deeply seated gender iden tity conflict. With psychotherapy being unsuccessful, it has been proven th at in carefully selected patients, gender reassignment or adjusting the bod y to the mind (both with hormones and surgery) is the best way to normalize their lives. Optimal treatment of these patients requires the multidiscipl inary approach of a gender team with the input of several specialties. Such a team consists of a nucleus of physicians who sees the patient more frequ ently : the psychiatrist, the endocrinologist, the plastic surgeon, the gyn ecologist and the urologist and a more peripheral group that sees the patie nts more incidentaly : the psychologist, the otorhinolaryngologist, the der matologist, the speech therapist, the lawyer, the nurse and the social work er. Between 1987 and 1999, a total of 71 male-to-female (MTF) and 54 female-to- male transsexuals have undergone gender confirming surgery in our hospital. This article gives a review and an update on the different surgical proced ures as well as on the outcome in our patient population. The results in th is series of patients clearly demonstrate that a close cooperation of the d ifferent surgical specialties, within our multidisciplinary gender team, is the key to success in treating transsexual patients.