Long-term follow-up of individuals undergoing sex reassignment surgery: Psychiatric morbidity
and mortality
Sammanfattning
Background: There is a lack of long-term register-based follow-up studies of sex-reassigned
individuals concerning mortality and psychiatric morbidity. Accordingly, the present study
investigated both mortality and psychiatric morbidity using a sample of individuals with
transsexualism which comprised 98% (n = 104) of all individuals in Denmark. Aims: (1) To investigate
psychiatric morbidity before and after sex reassignment surgery (SRS) among Danish individuals
who underwent SRS during the period of 1978-2010. (2) To investigate mortality among Danish
individuals who underwent SRS during the period of 1978-2010. Method: Psychiatric morbidity and
mortality were identified by data from the Danish Psychiatric Central Research Register and the
Cause of Death Register through a retrospective register study of 104 sex-reassigned individuals.
Results: Overall, 27.9% of the sample were registered with psychiatric morbidity before SRS and
22.1% after SRS (p = not significant). A total of 6.7% of the sample were registered with psychiatric
morbidity both before and after SRS. Significantly more psychiatric diagnoses were found before SRS
for those assigned as female at birth. Ten individuals were registered as deceased post-SRS with an
average age of death of 53.5 years. Conclusions: No significant difference in psychiatric morbidity or
mortality was found between male to female and female to male (FtM) save for the total number of
psychiatric diagnoses where FtM held a significantly higher number of psychiatric diagnoses overall.
Despite the over-representation of psychiatric diagnoses both pre- and post-SRS the study found that
only a relatively limited number of individuals had received diagnoses both prior to and after SRS.
This suggests that generally SRS may reduce psychological morbidity for some individuals while
increasing it for others.