No abstract available.
Transsexualism*

No abstract available.
Diagnosis* ; Transsexualism*

The traditional binary classification of gender is repeatedly challenged throughout history with the presence of transgenders. Under the umbrella of transgenderism is transsexualism which pertains to individuals who identify with or desire to become the opposite sex. Transsexualism or Gender Dysphoria is classified as a medical condition under ICD 10 and DSM-5. The proposed treatment is sex reassignment that includes all treatments carried out to adapt to the desired sex. Sex reassignment involves a multidisciplinary approach wherein the psychiatrist or mental health practitioner, endocrinologist and surgeon play active roles. Certain legal and ethical issues exist in the treatment of transsexualism. This article provides a review of psychological, medical and surgical issues in the evaluation and treatment of Transgender individuals, with an Asian perspective, and in the context of an actual case.
Gender Dysphoria ; Transsexualism ; Transgender Persons

Total phallic reconstruction may be necessary in various conditions such as traumatic or surgical loss of the penis, congenital penile absence, micropenis, pseudohermaphroditism and transsexualism In spite of recent advances in free tissue transfers and microneurovascular techniques, which have improved the results of total penile reconstruction, this operation still remains one of the greatest challenges in genitourinary surgery. And the simulation of erection remains most difficult goal to achieve especially in patients with congenital micropenis or female-to-male transsexuals. We have performed penile reconstruction in 6 patients since 1989, utilizing radial forearm osteocutaneous flap. The most common complication is related to neourethra and the most difficult problem is to obtain satisfactory penile rigidity, especially in patients with congenital micropenis. We conclude that there is a need for specially designed stiffeners which is specifically tailored to the abnormal perineal anatomy of these patients, as well as additional surgical improvement in urethral reconstruction.
Disorders of Sex Development ; Forearm ; Humans ; Male ; Penis ; Transsexualism

Sex segregation in competitive sports is regarded as fair. Before puberty boys and girls do not differ in height, muscle and bone mass. Testosterone (T) exposure during puberty leads to an ultimate average greater height in men of 12-15 cm, longer and larger bones and muscle mass and strength and higher hemoglobin levels. Postpubertal androgen ablation reverses, at least in part, previous anabolic effects of T on muscle, bone mineral density and hemoglobin but the long bones remain longer and wider. T administration dose dependently increases muscle mass and maximal voluntary strength. Therefore, exogenous androgens, being performance enhancing drugs, are banned for all athletes. An issue is the participation in competitive sports of people with errors of sexual differentiation and particularly transsexuals who have been sex-reassigned. In view of the effects of T, a clear demarcation is whether sex reassignment has taken place before or after hormonal puberty. Pubertal effects of T are in part reversible but there is no reliable evidence as to its completeness. The International Olympic Committee (IOC) has taken an inevitably arbitrary decision with regard to participation of sex-reassigned transsexuals in elite sports: sex reassignment must have taken place at least two years earlier, hormone treatment must be appropriate for the reassigned sex and the reassigned sex must be legally recognized. The IOC policy is not binding for other organizations.
Female ; Humans ; Male ; Sports ; Testosterone ; administration & dosage ; Transsexualism

Trsnssexualism, one of the gender identity disorders, has been increasing and evokes a serious social problem. The role of sex reassignment surgery in these patients are still controversial but in properly selected patients sex reassignment surgery is the best way to normalize their lives. However. guidelines for the proper selection of the patients for surgery is not yet established in Korea So. we present our experiences of two male transsexuals treated with rectosigmoid vaginoplasty and introduce the prerequisites to sex reassienment surgery.
Gender Identity ; Humans ; Korea ; Male* ; Sex Reassignment Surgery* ; Social Problems ; Transsexualism*

Male transsexualism is characterized by a life-long preference for the feminine role and the conviction of belonging to the female sex. The final and most characteristic expression of transsexualism is the desire to achieve the anatomical appearance of the opposite sex by either surgical or hormonal means. Since the skin graft technique of McIndoe, a number of operative procedures were evolved. Nowadays in order to construct neovaginas in male transsexuals, the inversion of penile flap or that of penile and scrotal skin flap is performed as a primary trial. Penile and scrotal skin flap have better functional results, but the cosmetic results are not satisfactory because of the prolapse of scrotal skin. In our studies, the vaginoplasty using penile and scrotal skin flap has been successfully used for 26 male transsexuals in whom their penis and scrotum were well preserved. We used scrotal skin flap modified by 8 cm wide. Additionally we made partial prepuce with dorsal neurovascular bundle into neoclitoris. Follow-up period ranged from 4 months to 22 months. The depth and width of neovagina was desirable. The cosmesis and physiologic benefit to the patient's satisfaction with the operation were reliable.
Female ; Follow-Up Studies ; Humans ; Male* ; Penis ; Prolapse ; Scrotum ; Skin* ; Surgical Procedures, Operative ; Transplants ; Transsexualism*

Transsexualism is a variety and complexity of conditions to the desire for sex change and may require medical treatments over psychological evaluations in some patients. Consequently, there is a potential confusion in the determination of anatomical sex in transsexuals arising from administration of hormone and/or sex reassignment surgery. In this article, we represent a case of a 52-year-old "woman"found dead on the road-side. "She"was naked on the scene and supposed to be murdered by strangulation of he neck. Surprisingly, autopsy findings as well as DNA typing revealed that "she"was transsexual once a man. We discuss medicolegal problems posed by medico-surgical treatment in transsexuals.
Autopsy* ; DNA Fingerprinting ; Female ; Homicide ; Humans ; Middle Aged ; Neck ; Sex Reassignment Surgery ; Transsexualism

PURPOSE: Transsexualism is considered to be the extreme end of the spectrum of gender identity disorders characterized by, among other things, a pursuit of sex reassignment surgery(SRS). We evaluated psychologic status, health-related quality of life in female-to-male (FTM), male-to-female(MTF) transgender individuals. METHODS: We used the Minnesota Multiphasic Personality Inventory, Beck Anxiety Inventory, Beck Depression Inventory, Moudsley obsessive-compulsive Inventory, SCL-90-R, Short-Form 36-Question Health Survey version 2(SF-36v2). We enrolled 40 transsexual participants. RESULTS: Analysis of quality of life health concepts demonstrated statistically significant(p<0.01) diminished quality of life among the transsexual participants as compared to the Korea male and female population. FTM transgender participants reported more higher hostile, phobic than MTF transgenders. Overall, in all psychologic status examination, Transgender individuals are within normal population boundary. On all category, result is improved post-operatively. CONCLUSION: Transgender participants reported mental status within normal boundary. SRS improved their quality of life and mental stability.
Anxiety ; Depression ; Female ; Gender Identity ; Health Surveys ; Humans ; Korea ; Male ; MMPI ; Quality of Life ; Transgender Persons ; Transsexualism

Transsexualism refers to a condition or belief which results in gender dysphoria in individuals and makes them insist that their biological gender is different from their psychological and experienced gender. Although the etiology of gender dysphoria (or transsexualism) is still unknown, different neuroimaging studies show that structural and functional changes of the brain result from this sexual incongruence. The question here is whether these reported changes form part of the etiology of transsexualism or themselves result from transsexualism culture, behaviors and lifestyle. Responding to this question can be more precise by consideration of cultural neuroscience concepts, particularly the culture–behavior–brain (CBB) loop model and the interactions between behavior, culture and brain. In this article, we first review the studies on the brain of transgender people and then we will discuss the validity of this claim based on the CBB loop model. In summary, transgender individuals experience change in lifestyle, context of beliefs and concepts and, as a result, their culture and behaviors. Given the close relationship and interaction between culture, behavior and brain, the individual's brain adapts itself to the new condition (culture) and concepts and starts to alter its function and structure.
Brain* ; Gender Dysphoria ; Gender Identity ; Life Style ; Neuroimaging ; Neurosciences ; Transgender Persons ; Transsexualism*