a Department of Medical Psychology , Center of Expertise on Gender Dysphoria, and Department of Plastic, Reconstructive & Hand Surgery, VU University Medical Center , Amsterdam , The Netherlands.
b Center of Sexology and Gender, Ghent University Hospital , Ghent , Belgium.
J Sex Marital Ther. 2018 Feb 17;44(2):138-148. doi: 10.1080/0092623X.2017.1326190. Epub 2017 Jun 12.
We assessed the outcomes of gender-affirming surgery (GAS, or sex-reassignment surgery) 4 to 6 years after first clinical contact, and the associations between postoperative (dis)satisfaction and quality of life (QoL). Our multicenter, cross-sectional follow-up study involved persons diagnosed with gender dysphoria (DSM-IV-TR) who applied for medical interventions from 2007 until 2009. Of 546 eligible persons, 201 (37%) responded, of whom 136 had undergone GAS (genital, chest, facial, vocal cord and/or thyroid cartilage surgery). Main outcome measures were procedure performed, self-reported complications, and satisfaction with surgical outcomes (standardized questionnaires), QoL (Satisfaction With Life Scale, Subjective Happiness Scale, Cantril Ladder), gender dysphoria (Utrecht Gender Dysphoria Scale), and psychological symptoms (Symptom Checklist-90). Postoperative satisfaction was 94% to 100%, depending on the type of surgery performed. Eight (6%) of the participants reported dissatisfaction and/or regret, which was associated with preoperative psychological symptoms or self-reported surgical complications (OR = 6.07). Satisfied respondents' QoL scores were similar to reference values; dissatisfied or regretful respondents' scores were lower. Therefore, dissatisfaction after GAS may be viewed as indicator of unfavorable psychological and QoL outcomes.
我们评估了首次临床接触后 4 至 6 年的性别肯定手术（GAS，或性别重置手术）的结果，以及手术后（不满意）和生活质量（QoL）之间的关联。我们的多中心、横断面随访研究涉及被诊断为性别障碍（DSM-IV-TR）并在 2007 年至 2009 年期间申请医疗干预的人。在 546 名合格者中，有 201 人（37%）做出了回应，其中 136 人接受了 GAS（生殖器、胸部、面部、声带和/或甲状软骨手术）。主要观察指标为手术程序、自我报告的并发症和对手术结果的满意度（标准化问卷）、生活质量（生活满意度量表、主观幸福感量表、坎特里尔阶梯）、性别障碍（乌得勒支性别障碍量表）和心理症状（症状清单-90）。术后满意度为 94%至 100%，具体取决于所进行的手术类型。有 8 名（6%）参与者报告不满意和/或后悔，这与术前心理症状或自我报告的手术并发症有关（OR=6.07）。满意的受访者的 QoL 评分与参考值相似；不满意或后悔的受访者的评分较低。因此，GAS 后不满意可能被视为不良心理和 QoL 结果的指标。
