Department of Plastic Surgery and Hand Surgery, Universitätsspital Zürich; Department of Plastic, Reconstructive & Aesthetic Surgery and Hand Surgery, Center for Gender Variance, Universitätsspital Basel.
Dtsch Arztebl Int. 2019 Apr 12;116(15):253-260. doi: 10.3238/arztebl.2019.0253.
The prevalence of persons who are born with primary and secondary male sexual characteristics but feel that they are female (trans women) is ca. 5.48 per 100 000 males in Germany. In this article, we provide a detailed overview of the currently available data on quality of life after male-to-female sex reassignment surgery.
This review is based on publications retrieved by a systematic literature search that was carried out in the PubMed, EMBASE, Web of Science, and PsycINFO databases in March 2017.
The 13 articles (11 quantitative and 2 mixed quantitative/qualitative studies) that were found to be suitable for inclusion in this review contained information on 1101 study participants. The number of trans women in each study ranged from 3 to 247. Their mean age was 39.9 years (range: 18-76). Seven different questionnaires were used to assess postoperative quality of life. The findings of the studies permit the conclusion that sex reassignment surgery beneficially affects emotional well- being, sexuality, and quality of life in general. In other categories (e.g., "freedom from pain", "fitness", and "energy"), some of the studies revealed worsening after the operation. All of the studies were judged to be at moderate to high risk of bias. The drop-out rates, insofar as they were given, ranged from 12% to 77% (median: 56%).
Current studies indicate that quality of life improves after sex reassign- ment surgery. The available studies are heterogeneous in design. In the future, prospective studies with standardized methods of assessing quality of life and with longer follow-up times would be desirable.
在德国，约有 5.48/10 万男性具有原发性和继发性男性性特征，但自我认同为女性（跨性别女性）。本文详细概述了目前已有的关于跨性别女性行男变女性别重置手术后生活质量的相关数据。
本综述基于 2017 年 3 月在 PubMed、EMBASE、Web of Science 和 PsycINFO 数据库中进行的系统文献检索，检索到的相关文献包含了 13 篇文章（11 篇定量研究和 2 篇混合定量/定性研究）。这 13 篇文章纳入了 1101 名研究参与者。每篇文章纳入的跨性别女性人数为 3 至 247 人不等，平均年龄为 39.9 岁（范围：18-76 岁）。7 种不同的问卷被用于评估术后生活质量。研究结果表明，性别重置手术可显著改善情绪健康、性生活以及整体生活质量。在其他方面（如“无疼痛”、“健康状况”和“活力”），一些研究显示术后情况恶化。所有研究均存在中等到高度的偏倚风险。在报告的失访率中，最高值为 77%，最低值为 12%，中位数为 56%。
目前的研究表明，性别重置手术后生活质量会得到改善。但现有研究在设计上存在异质性。未来，需要开展采用标准化的生活质量评估方法和随访时间更长的前瞻性研究。
