TRANSSEXUALISM; A Sri Lankan experience: A descriptive study of epidemiological characteristics and management issues of transsexuals (TXLs) from a tertiary care clinic setting in Sri Lanka

P Ginige,N Gunawardena,A S Malalagama,P D L R Wijesinghe

doi:10.4038/joshhm.v4i0.70

Abstract

Introduction: A transsexual (TXL) is an individual who seeks or has commenced a social transition from natal gender to desired gender. (1) This transition usually involves hormone treatment or sex reassignment surgery (SRS). Epidemiological characteristics of TXLs in Sri Lanka (SL) has not been studied to date. Objective: The aim of this study is to describe the epidemiological characteristics and management of TXL clinic attendees at a tertiary care clinic setting in SL. Method: This is a descriptive cross sectional study. Data was collected retrospectively from routine clinic notes on demographic and management characteristics of TXLs registered in the psychiatry clinics of Teaching Hospital Peradeniya from their incept to 31st August 2018. Data were analyzed using SPSS-17. Results: Total number of TXLs were 71 with 31% male to female (MTF) TXLs and 69% female to male (FTM) TXLs . Ratio between FTM to MTF was 2:1. Majority were Sinhala Buddhists between 31-35yrs. Unemployment was seen in 23%. A comorbid psychiatric condition was diagnosed in 20% on presentation. The clinic has increasingly drained TXLs from almost all the provinces in SL over time. Hormonal treatment was received by 65% while 25% received some SRS. Majority were distressed due to deficiencies in organizing legal documents, hormone administration and SRS. Conclusions: There is an increasing trend in help seeking by TXL individuals. Many were unable to have SRS. There is a major gap in service provision. The study creates awareness on the distribution of the TXLs in SL, their epidemiological characteristics and deficiencies in management.

Highlights

A transsexual (TXL) is an individual who seeks or has commenced a social transition from natal gender to desired gender. [1] This transition usually involves hormone treatment or sex reassignment surgery (SRS)
Gender Dysphoria (GD) is the broad term used for the distress caused by incongruency between perceived and assigned genders in individuals who identify with a gender different from their gender assigned at birth.[1]. A transsexual (TXL) is an individual who wishes to make the body as conformed as possible to the preferred sex through hormonal or surgical treatment.[1]. Estimating global prevalence rates for GD is not easy
A meta-analysis by Arcelus et al reviewed 21 studies and concluded that the prevalence of ‘transsexualism’ in adult males was 1:14 705 and 1:38 461 in adult females.[3]. In Asia, countries like Thailand and Singapore have a vast transgender community compared to the western countries; Singapore prevalence rates are high with prevalence rates of 35.2:100,000 or 1:2,900 male-to-female (MTF) and 12.0:100,000 or 1:8,300, female-to-male (FTM) TXLs.[4]. GD is more prevalent among natal males.[5]

Summary

Introduction

A transsexual (TXL) is an individual who seeks or has commenced a social transition from natal gender to desired gender. [1] This transition usually involves hormone treatment or sex reassignment surgery (SRS). Gender Dysphoria (GD) is the broad term used for the distress caused by incongruency between perceived and assigned genders in individuals who identify with a gender different from their gender assigned at birth.[1] A transsexual (TXL) is an individual who wishes to make the body as conformed as possible to the preferred sex through hormonal or surgical treatment.[1] Estimating global prevalence rates for GD is not easy. A meta-analysis by Arcelus et al reviewed 21 studies and concluded that the prevalence of ‘transsexualism’ in adult males was 1:14 705 and 1:38 461 in adult females.[3] In Asia, countries like Thailand and Singapore have a vast transgender community compared to the western countries; Singapore prevalence rates are high with prevalence rates of 35.2:100,000 or 1:2,900 male-to-female (MTF) and 12.0:100,000 or 1:8,300, female-to-male (FTM) TXLs.[4] GD is more prevalent among natal males.[5]. National Center for Transgender Equity and the National Gay and Lesbian Task Force in USA 2011 found in their survey that Lesbian, Gay, Bisexual and Transgender (LGBT) people are more than twice as likely as blacks or Jews to be subjected to violent hate crime.[6]

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