De Cuypere Griet, T'Sjoen Guy, Beerten Ruth, Selvaggi Gennaro, De Sutter Petra, Hoebeke Piet, Monstrey Stan, Vansteenwegen Alfons, Rubens Robert
Department of Sexology and Gender Problems, University Hospital Ghent, Ghent, Belgium.
Arch Sex Behav. 2005 Dec;34(6):679-90. doi: 10.1007/s10508-005-7926-5.
A long-term follow-up study of 55 transsexual patients (32 male-to-female and 23 female-to-male) post-sex reassignment surgery (SRS) was carried out to evaluate sexual and general health outcome. Relatively few and minor morbidities were observed in our group of patients, and they were mostly reversible with appropriate treatment. A trend toward more general health problems in male-to-females was seen, possibly explained by older age and smoking habits. Although all male-to-females, treated with estrogens continuously, had total testosterone levels within the normal female range because of estrogen effects on sex hormone binding globulin, only 32.1% reached normal free testosterone levels. After SRS, the transsexual person's expectations were met at an emotional and social level, but less so at the physical and sexual level even though a large number of transsexuals (80%) reported improvement of their sexuality. The female-to-males masturbated significantly more frequently than the male-to-females, and a trend to more sexual satisfaction, more sexual excitement, and more easily reaching orgasm was seen in the female-to-male group. The majority of participants reported a change in orgasmic feeling, toward more powerful and shorter for female-to-males and more intense, smoother, and longer in male-to-females. Over two-thirds of male-to-females reported the secretion of a vaginal fluid during sexual excitation, originating from the Cowper's glands, left in place during surgery. In female-to-males with erection prosthesis, sexual expectations were more realized (compared to those without), but pain during intercourse was more often reported.
对55名变性手术后的患者（32名男变女和23名女变男）进行了一项长期随访研究，以评估性健康和总体健康状况。在我们的患者群体中观察到的发病率相对较少且较轻，并且通过适当治疗大多可以逆转。在男变女患者中发现有出现更多总体健康问题的趋势，这可能与年龄较大和吸烟习惯有关。尽管所有持续接受雌激素治疗的男变女患者由于雌激素对性激素结合球蛋白的作用，其总睾酮水平处于正常女性范围内，但只有32.1%的患者达到正常的游离睾酮水平。变性手术后，变性者在情感和社会层面的期望得到了满足，但在身体和性层面则不然，尽管大量变性者（80%）报告其性功能有所改善。女变男患者自慰的频率明显高于男变女患者，并且在女变男组中出现了性满意度更高、性兴奋度更高以及更容易达到性高潮的趋势。大多数参与者报告性高潮感觉发生了变化，女变男患者的性高潮更强烈且持续时间更短，男变女患者的性高潮则更强烈、更平稳且持续时间更长。超过三分之二的男变女患者报告在性兴奋时有阴道分泌液，其来源于手术时保留的尿道球腺。在植入勃起假体的女变男患者中，性期望得到了更多实现（与未植入者相比），但性交时疼痛的报告更为常见。
