Introduction: Quality of life in transsexual persons after transition is among the most important outcome factors.
Methods: A specialist center cross-sectional study in 193 transsexual women and 128 transsexual men (mean age 42.5 years) after on average 7.4 years of cross-sex hormone therapy and 6.6 years since sex reassignment surgery (SRS), compared to an age-and gender matched control population (1 to 3 matching). Self-reported physical and mental health using the Dutch version of the SF-12 Health survey. Medical history and postsurgical outcome were addressed by a new-developed questionnaire.
Results: Compared to age-matched control men and women, transsexual women scored worse both on physical and mental functioning (all P values <0.001). Transsexual men reported equal degree of physical functioning compared to control women, but scored worse than control men. Mental well-being in transsexual men was poorer in comparison with control men and women (all P values <0.001). In the total sample, age was negatively correlated with physical functioning, whereas educational level was positively associated. Patients with the lowest income quartile had worse physical and mental functioning compared to the others. Participants who lived with a partner had a better mental well-being. In transsexual men, having children was positively associated with mental-well being; in transsexual women the opposite was observed. Experiences of complications of phalloplasty, erection prosthesis or vaginoplasty were not associated with quality of life scores. However, satisfaction with these procedures was positively related to mental well-being. Likewise, both in transsexual men and women satisfaction with hormonal therapy was positively associated with mental and physical functioning (both P<0.001).
Conclusion: Results of the current study indicate transsexual men and women after long-term cross-sex hormone treatment and SRS report worse mental well being compared to a control population. QOL in transsexual persons showed a strong association with treatment satisfaction, social and economical determinants.