SEXUAL FUNCTIONING IN TRANSWOMEN AFTER SEX REASSIGNMENT SURGERY

Carlo Molo Foundation -onlus- C.I.D.I.Ge.M. Centro Interdipartimentale Disturbi dell’Identità di Genere Molinette University of Turin SEXUAL FUNCTIONING IN TRANSWOMEN AFTER SEX REASSIGNMENT SURGERY Chiara CRESPI, Valentina MINECCIA, Chiara MANIERI, Mariateresa MOLO

AIMS To compare the quality of sexual life after Sex Reassignment Surgery (S.R.S.) between transwomen and a control group of women To investigate the sexual functioning in transwomen after SRS To compare the sexual functioning between transwomen and control women

MATERIALS AND METHOD

The Sample Ntot=50 50% (N=25)‏ 50% (N=25)‏

SOCIAL AND DEMOGRAPHIC CARACTERISTICS

Study project The study is based on: • Clinical Data • World Health Organization Quality of Life Questionnaire (WHOQOL-100) • Female Sexual Function Index (F.S.F.I.)‏ Almost two years after the SRS

CLINICAL DATA • Sexual orientation; • Presence of a stable relationship; • Surgical complications;

CLINICAL DATA

WHOQOL-100 QUESTIONNAIRE 24 subscales - Interpersonal relationships - Social support - Sexual activity - Safety - Home environment - Financial resources - Health care • Opportunities for new knowledge - Recreation - Physical environment - Transports - Spirituality - Pain - Energy - Sleep - Positive emotions - Reasoning skills - Self-Esteem - Body Image - Negative emotions - Mobility - Daily living activities - Drug addiction - Work ability

Female Sexual Function Index (F.S.F.I) - Desire - Arousal - Lubrication - Orgasm - Sexual Satisfaction - Pain - Total Score* *Cut off ≤26,55: risk for sexual dysfunction (Wieger et al., Journal of Sex & Marital Therapy, 31:1-20, 2005)

RESULTS

AIMS To compare the quality of sexual life between transwomen and control women To investigate the sexual functioning in transwomen after SRS To compare the sexual functioning between transwomen and control women

THE COMPRISON BETWEEN MTF AND CONTROL WOMEN IN THE QUALITY OF SEXUAL LIFE Sample N Mean SD SE ------------------------------------------------------------------------------------------- 1. Data1_QOLSexDIG 25 59.032 21.121 4.2242 2. Data1_QOLSexC 25 61.008 20.66535 4.13307 ------------------------------------------------------------------------------------------- Difference of Means: -1.976 t DoF P Value ------------------------------------------------ -0.33436 48 0.73957 *Two Sample Independent t-Test ------------------------------------------------ * *Cut off≥50

Transwomen Sexual Functioning Index: FSFI *Cut off ≤26,55 risk for sexual dysfunction (Wieger et al., Journal of Sex & Marital Therapy, 31:1-20, 2005)

TRANSWOMEN • The sexual DESIRE in terms of frequency and level generally is HIGH; • The AROUSAL (frequency, level, confidence and satisfaction) is HIGH; • The LUBRICATION in terms of frequency, difficulty and frequency in mantaining is in average /with a tendency to lower scores; • The frequency, the difficult and the satisfaction about ORGASMis in average with a tendency to lower scores; • The SATISFACTION is in average • The PAIN in terms of frequency during/following vaginal penetration is generally HIGH; • The Total Score is borderline, close to the risk of sexual dysfunctions

Sexual functioning : F.S.F.I. Transwomen Control women Mean ±SD Mean ±SD *Cut off ≤26,55 risk for sexual dysfunction (Wieger et al., Journal of Sex & Marital Therapy, 31:1-20, 2005)

CONTROL WOMEN versus TRANSWOMEN • The control womens’ DESIRE in terms of frequency and level is LOWER than Transwomen • The AROUSAL is HIGH in both groups • The LUBRICATION and the ORGASM (frequency, level, difficult, confidence and satisfaction) are HIGH in the control groupwhilethey are in an average level in the Trans women sample • The SATISFACTION is in an average level in both groups • The control group’s PAIN in terms of frequency during/following vaginal penetration is LOWER than Transwomen • The TOTAL SCORE is in average; normative cluster (i.e no risk of sexual dysfunctions)

1.After SRS the Quality of Sexual Life is good without statistically differences from control women CONCLUSIONS 3. The main problems are concerning Lubrication, orgasm and pain 2.Transwomen showed some difficults in sexual functioning

Problems about lubrication are related to the kind of surgery (only two patients made “rectosigmoid flap”) CONCLUSIONS Problems about orgasm and pain are probably related to the difficulty in integrating new genitalia in the Body Image We think that after SRS a specific psychosexual intervention is necessary

SEXUAL FUNCTIONING IN TRANSWOMEN AFTER SEX REASSIGNMENT SURGERY