Transsexualism: Treatment Outcome of Compliant and Noncompliant Patients

ABSTRACT

The objective of the study was a follow-up of the treatment outcome of Finnish transsexuals who sought sex reassignment during the period 1970–2002 and a comparison of the results and duration of treatment of compliant and noncompliant patients. Fifteen male-to-female transsexuals and 17 female-to-male transsexuals who had undergone hormone and surgical treatment and legal sex reassignment in Finland completed a questionnaire on psychosocial data and on their experience with the different phases of clinical assessment and treatment. The changes in their vocational functioning and social and psychic adjustment were used as outcome indicators. The results and duration of the treatment of compliant and noncompliant patients were compared.

The patients benefited significantly from treatment. The noncompliant patients achieved equally good results as the compliant ones, and did so in a shorter time. A good treatment outcome could be achieved even when the patient had told the assessing psychiatrist a falsified story of his life and sought hormone therapy, genital surgery, or legal sex reassignment on his own initiative without a recommendation from the psychiatrist. Based on these findings, it is recommended that the doctor-patient relationship be reconsidered and founded on frank cooperation.

KEYWORDS:

• transsexualism
• sex reassignment surgery
• legal sex reassignment
• treatment compliance

Acknowledgments

The material of this article has been excerpted from a large, ongoing follow-up study on Finnish patients who have contacted the Health Care Services due to gender identity problems during the period 1970–2002. The article was written by Pimenoff and critically revised by Pfäfflin. Findings of this ongoing study have been published in German in: Pimenoff, V. (2008). Geschlechtsumwandlung in Finnland, 1970–2002. Eine historische und empirische Studie zu Geschlechtsumwandlungen unter den Regelungen des Kastrationsgesetzes bis zur Einführung des finnischen Transsexuellengesetzes. Monograph available online at http://vts.uni-ulm.de/docs/2008/6433/vts_6433_8690.pdf. Text and figures presented here have not been published before.

None of the authors has to disclose any financial or other conflicts of interest that might affect her/his work.