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

Gender is determined at fertilization. However, gender mentally decision is another issue. Transgender is a familiar word in general populations, but the definition of transgender and exact managements are not familiar to physicians including gynecologists. Transgender is not well received for health care benefits, because primary care about the transgender is not known to the physicians. Transgender is hidden in the social health care system, Transgender individuals wish to be assisted to feminize or masculinize their bodies including gestures, facial expression etc. Primary health care for transgender diversely includes psychological, medical, and surgical treatments. Basic management of transgender is hormonal therapy, thus we should guide the management for appropriate hormone therapies. Our review article provides guidelines for the gynecologist to assist and to help the transgender for primary care.
Delivery of Health Care ; Facial Expression ; Fertilization ; Gestures ; Humans ; Primary Health Care ; Transgender Persons ; Transsexualism

PURPOSE: The purpose of this study was to identify the attitude of nurses toward transsexuals. METHOD: The Q-methodology which provides a method of analyzing the subjectivity of each item was used. Twenty-nine nurses classified the 50 selected Q-statements into a normal distribution using a 9 point scale. The collected data was analyzed using the Quanl PC program. RESULT: Four types of attitudes toward transsexuals were identified. The first type (humanitarian acceptance) showed an attitude of respecting transsexuals as human beings and understanding and accepting their desires and difficulties. The second type (superficial understanding) understood the psychological conflicts and suffering of transsexuals but could not accept them as members of families or society. The third type (insufficient understanding) did not feel a sense of rejection toward transsexuals but showed a lack of understanding of their desires and difficulties. The fourth type (rejection) failed to understand the desires and difficulties of transsexuals and showed a sense of rejection toward them, in addition to regarding them as sexually immoral people. CONCLUSION: The results of the study indicate that different approaches of educational programs based on the four types of attitudes toward transsexuals are recommended.
Adult ; *Attitude of Health Personnel ; Demography ; Female ; Humans ; Models, Educational ; Nursing Staff/*psychology ; Q-Sort ; Questionnaires ; *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