Male transsexuals: a long-term follow-up after sex reassignment operations.

Since 1953 the Danish law permitting castration has been applied to transsexuals. Case histories are here reported on ten cases, operated up to 19 years before the follow-up. Six of these presented typical syndromes. In some of the early cases the reluctance on the part of therapists to adopt an active therapy has been too great. Two subjects had died before the follow-up investigation, but both had formerly reported satisfaction with the treatment to their therapists. One case- happily married - had emigrated with the husband. At the interviews the three others confirmed happiness and satisfaction with their female way of life. They are living in resonably good social circumstances. Three cases were not typical. A promiscuous massive sexual activity exhibited by these patients had made it very difficult to endorse a surgical solution to their strongly presented with to obtain sex reassignment. At the follow-up all three were very satisfied with their female role. After several years in their new sex role, two of these were still promiscucos. The last case presents unusually complicated sex role problems. He continues to live as a male, but he still insists 19 years after castration, that the operation saved his life. In spite of his handicap, he claims to be satisfied that he obtained the permit. None of the operated cases committed suicide, but one case - not operated but living as a female - developed a paranoid reaction resulting in suicide.