Hage J J
Department of Plastic and Reconstructive Surgery, Academic Hospital, Free University, Amsterdam, The Netherlands.
Med Sci Law. 1995 Jan;35(1):17-24. doi: 10.1177/002580249503500105.
Prior to considering surgical reassignment, the key issue for the surgeon is to establish beyond reasonable doubt that the gender dysphoria or transsexual feeling is genuine and that surgical reassignment will be beneficial. For this he will need the expertise of a reputable behavioural scientist. To determine whether the patient is physically fit for surgery, the surgeon may lean on the expertise of an endocrinologist with substantial personal experience in the field of hormonal treatment of transsexuals. Sex reassignment for M-->F transsexuals may be completed in one operation, leading to acceptable cosmetic and functional results, provided the surgery and postoperative treatment are performed with a high degree of expertise. Present generation operative techniques for phalloplasty in F-->M transsexuals still do not meet all requirements. The term 'one-stage phalloplasty' is deceiving. Genital reassignment surgery in F-->M transsexuals can seldom be achieved in one stage. Prior to any form of this kind of surgery, this should be made clear to the patient. F-->M and M-->F transsexuals will become irreversibly infertile by the orchiectomy and the oöphoro-hysterectomy usually performed on them. Diagnosis of, and counselling and treatment for, gender dysphoria should be restricted to reputable gender teams. These teams should exchange information.
在考虑进行手术变性之前，外科医生面临的关键问题是要毫无疑问地确定性别焦虑或易性癖情感是真实的，并且手术变性将是有益的。为此，他需要一位声誉良好的行为科学家的专业知识。为了确定患者身体是否适合手术，外科医生可能会依靠一位在内分泌治疗易性癖领域有丰富个人经验的内分泌学家的专业知识。对于男变女的易性癖者，性别重置手术可以一次完成，只要手术和术后治疗具备高度的专业水平，就能取得可接受的外观和功能效果。目前针对女变男易性癖者的阴茎成形术技术仍不能满足所有要求。“一期阴茎成形术”这个术语具有误导性。女变男易性癖者的生殖器重置手术很少能一次完成。在进行任何形式的此类手术之前，都应向患者明确说明这一点。男变女和女变男的易性癖者通常接受的睾丸切除术和卵巢子宫切除术会使他们不可逆转地不育。性别焦虑的诊断、咨询和治疗应仅限于声誉良好的性别治疗团队。这些团队应该交流信息。
