Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden
Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden
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DOI：
10.1371/journal.pone.0016885
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发表时间：
2011-02-22
期刊：
影响因子：
3.7
通讯作者：
Landen, Mikael
中科院分区：
文献类型：
--
作者：
Dhejne, Cecilia;Lichtenstein, Paul;Landen, Mikael
内容：易性癖的治疗方法是变性，包括荷尔蒙治疗和手术，旨在使人的身体尽可能与异性一致。有一个缺乏长期的，后续的研究后sexreassign.Objective：估计死亡率，发病率和犯罪率手术后的变性persons.Design：人口为基础的匹配队列研究。地点：瑞典，1973 - 2003。对象：1973 - 2003年瑞典所有324名性别重新分配的人（191名男性为女性，133名女性为男性）。随机对照组（10：1）分别按出生年份和出生性别或重新分配的（最终）性别进行匹配。主要结果测量：死亡率和精神病发病率的风险比（HR）和95%置信区间（CI）用考克斯回归模型获得，该模型在性别重新分配前校正了移民身份和精神病发病率结果：随访期间，性别重新分配者的总死亡率（aHR 2.8; 95% CI 1.8 - 4.3）高于相同出生性别的对照组，特别是自杀死亡（aHR 19.1; 95% CI 5.8 - 62.9）。性别重新分配的人也有自杀企图（aHR 4.9; 95% CI 2.9 - 8.5）和精神病住院治疗（aHR 2.8; 95% CI 2.0 - 3.9）的风险增加。与重新分配性别的对照组进行比较，得到了类似的结果。女性对男性，但不是男性对女性，有更高的风险比他们各自的出生sexualcontrols.Conclusions：变性人，变性后，有相当高的死亡率，自杀行为和精神病发病率的风险比一般人群。我们的研究结果表明，性别重置，虽然减轻性别焦虑，可能不足以作为治疗易性癖，并应激发改善精神和躯体护理后，性别重置这一患者群体。
Context: The treatment for transsexualism is sex reassignment, including hormonal treatment and surgery aimed at making the person's body as congruent with the opposite sex as possible. There is a dearth of long term, follow-up studies after sex reassignment.Objective: To estimate mortality, morbidity, and criminal rate after surgical sex reassignment of transsexual persons.Design: A population-based matched cohort study. Setting: Sweden, 1973-2003.Participants: All 324 sex-reassigned persons (191 male-to-females, 133 female-to-males) in Sweden, 1973-2003. Random population controls (10: 1) were matched by birth year and birth sex or reassigned (final) sex, respectively.Main Outcome Measures: Hazard ratios (HR) with 95% confidence intervals (Cl) for mortality and psychiatric morbidity were obtained with Cox regression models, which were adjusted for immigrant status and psychiatric morbidity prior to sex reassignment (adjusted HR [aHR]).Results: The overall mortality for sex-reassigned persons was higher during follow-up (aHR 2.8; 95% Cl 1.8-4.3) than for controls of the same birth sex, particularly death from suicide (aHR 19.1; 95% Cl 5.8-62.9). Sex-reassigned persons also had an increased risk for suicide attempts (aHR 4.9; 95% Cl 2.9-8.5) and psychiatric inpatient care (aHR 2.8; 95% Cl 2.0-3.9). Comparisons with controls matched on reassigned sex yielded similar results. Female-to-males, but not male-to-females, had a higher risk for criminal convictions than their respective birth sex controls.Conclusions: Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.