Quality of Life After Sex Reassignment Surgery: A Systematic Review and Meta-Analysis

Abstract

Context: Gender identity disorder (GID) or gender dysphoria is a disorder in which an individual identifies him/herself with the opposite sex. GID following sex reassignment surgery (SRS) is usually associated with severe distress and several limitations in the personal and social aspects of life as a transgender. Objectives: The current systematic review and meta-analysis aimed at evaluating the quality of life (QoL) after SRS in transgender individuals. Data Sources: A search was conducted in English databases, including PubMed, Scopus, PsycINFO, ScienceDirect, and Google Scholar. In addition, the reference lists of the included articles were reviewed without any time limitations. The final literature search was performed on 12 June 2017. Study Selection: All relevant cross sectional and observational studies were evaluated in the current review. The keywords included sex, gender, reassignment surgery, reassignment operation, sex change, sex reversal, transpersonal, sexual transition, gender dysphoria, transsexual, transgender, gender identity, male-to-female transsexual, female-to-male transsexual, quality of life, QoL, quality adjusted, and wellbeing. Data Extraction: After screening 941 articles, 16 studies were reviewed systematically, six of which were included in the meta-analysis. Comprehensive Meta-Analysis Software version 2 was used for all meta-analyses. Results: QoL improved after SRS in some dimensions, including bodily pain, emotional role, and mental health in male-to-female (MtF) transsexuals, and physical function and physical role in female-to-male (FtM) transsexuals. Physical role, vitality, and social function in MtF transsexuals were not significantly different from the general population. In other words, bodily pain, general health, social function, vitality, mental health, and emotional role in FtM transsexuals, as well as physical function and general health in MtF transsexuals, were lower than the general population. Conclusions: Based on the findings, SRS could improve some dimensions of QoL, including bodily pain, emotional role, and mental health in MtF transsexuals, and physical function as well as physical role in FtM transsexuals. Nevertheless, further research is necessary in this area.