Congress Paper Abstract

Post-operative functioning in a group of adolescent transsexuals

Dr Peggy Cohen Kettenis, Department of Child and Adolescent Psychiatry, 

Email: p.t.cohenkettenis@psych.azu.nl

Starting hormone treatment before the age of 18 is a subject of much debate among professionals. They are generally reluctant to begin these rather invasive procedures when the adolescent is still developing. Because of this ongoing development, it is felt that adolescents cannot make a sensible decision and that the risk of post-operative regret is high. However, one important argument for commencing the administration of cross-sex hormones earlier - for example, during adolescence - is that the physical outcome can be expected to be more satisfactory by comparison with starting later, at an age at which the body has already been fully developed into woman or man. Thus an early start could be expected to have positive effects on feelings of psychological well-being and social adaptation.

Since 1987 adolescents with gender identity disorder are diagnosed and treated at the gender clinic in the Academic Hospital in Utrecht. In our paper two follow-up studies will be presented. The treated patients were invited to attend the gender clinic, 1 to 6 years after the completion of the sex reassignment procedure; in one study patients who did not start treatment or were rejected were also included in the follow-up.

The aim of the studies was to examine how this relatively young group was functioning physically, psychologically and socially. An extensive structured interview and a battery of psychological tests was administered by someone not involved in the diagnosis and treatment of transsexuals. Important domains of inquiry were: satisfaction with the outcome of the surgical operations, effects of hormonal treatment, psychological functioning, social functioning and gender role adaptation. These post-treatment data concerning each of these domains will be compared to the patients’ own pre-treatment data.

The implications of our findings for the issue of when to begin the gender reassignment process will be considered.

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