sexual functioning in transwomen after sex reassignment surgery c.i.d.i.ge.m. centro...
TRANSCRIPT
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SEXUAL FUNCTIONING IN TRANSWOMEN
AFTER
SEX REASSIGNMENT SURGERY
C.I.D.I.Ge.M.Centro Interdipartimentale
Disturbi dell’Identità di Genere MolinetteUniversity of Turin
Chiara CRESPI, Valentina MINECCIA, Chiara MANIERI, Mariateresa MOLO
Carlo Molo
Foundation
-onlus-
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AIMS
To compare the quality of sexual life after Sex Reassignment Surgery (S.R.S.) between transwomen and a control group of women
To investigate the sexual functioning in transwomen after SRS
To compare the sexual functioning between transwomen and control women
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MATERIALS AND
METHOD
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MtF
CONTROLWOMEN
50%(N=25)
Ntot=50
50% (N=25)
The Sample
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TOT SAMPLE (N=50) MtF WOMEN
Sex 25(50%) 25(50%)
AGE, YEARS ( SD) 30,51 (9,89) 31,02(8,97)
EDUCATIONAL LEVEL, YEARS ( SD)
11,55 ( 3,28) 12,67(2,67)
MARITAL STATUS, N (%):
Single Married Cohabitant
16(64%) 17(68%) 2 (8%) 5 (20%) 7(28%) 3 (12%)
STABLE RELATIONSHIP
YES No
12(48%) 19(76%)13(52%) 6(24%)
SEXUAL ORIENTATION Eterosexual Omosexual
24(99%) 24(99%) 1(1%) 1(1%)
SOCIAL AND DEMOGRAPHIC CARACTERISTICS
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Study project
The study is based on:
• Clinical Data
• World Health Organization Quality of Life Questionnaire (WHOQOL-100)
• Female Sexual Function Index (F.S.F.I.)
Almost two years after the SRS
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CLINICAL DATA
Sexual orientation;
Presence of a stable relationship;
Surgical complications;
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TRANSWOMEN CONTROL WOMEN
STABLE RELATIONSHIP
YES No
12(48%) 13(52%) 19(76%) 6(24%)
SEXUAL ORIENTATION Eterosexual Omosexual
24(99%) 24(99%) 1(1%) 1(1%)
KIND of SURGERY Vaginoplasty Rectosigmoid flap
23(92%) 2(8%)
NO surgical complications
CLINICAL DATA
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- Pain
- Energy
- Sleep
- Positive emotions
- Reasoning skills
- Self-Esteem
- Body Image
- Negative emotions
- Mobility
- Daily living activities
- Drug addiction
- Work ability
- Interpersonal relationships
- Social support
- Sexual activity
- Safety
- Home environment
- Financial resources
- Health care
- Opportunities for new knowledge
- Recreation
- Physical environment
- Transports
- Spirituality
WHOQOL-100 QUESTIONNAIRE 24 subscales
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- Desire
- Arousal
- Lubrication
- Orgasm
- Sexual Satisfaction
- Pain
- Total Score*
Female Sexual Function Index (F.S.F.I)
*Cut off ≤26,55: risk for sexual dysfunction (Wieger et al., Journal of Sex & Marital Therapy, 31:1-20, 2005)
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RESULTS
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AIMS
To compare the quality of sexual life between transwomen and control women
To investigate the sexual functioning in transwomen after SRS
To compare the sexual functioning between transwomen and control women
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THE COMPRISON BETWEEN MTF AND CONTROL WOMEN IN THE QUALITY OF SEXUAL
LIFE
Sample N Mean SD SE ------------------------------------------------------------------------------------------- 1. Data1_QOLSexDIG 25 59.032 21.121 4.2242 2. Data1_QOLSexC 25 61.008 20.66535 4.13307 ------------------------------------------------------------------------------------------- Difference of Means: -1.976
t DoF P Value ------------------------------------------------ -0.33436 48 0.73957 *Two Sample Independent t-Test ------------------------------------------------
59,03 61
0102030405060708090
100
Quality of life score
MtF
Control Women
*Cut off≥50
*
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AIMS
To compare the quality of sexual life between transwomen and control women
To investigate the sexual functioning in transwomen after SRS
To compare the sexual functioning between transwomen and control women
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*Cut off ≤26,55 risk for sexual dysfunction (Wieger et al., Journal of Sex & Marital Therapy, 31:1-20, 2005)
Mean ±SD
Desire 4,3 1,2
Arousal 4,4 1,0
Lubrication 4,4 1,2
Orgasm 4,4 1,2
Satisfaction
4,3 1,5
Pain 3,7 1,6
TOTAL SCORE*
25,5 7,7
Transwomen Sexual Functioning Index: FSFI
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The sexual DESIRE in terms of frequency and level generally is HIGH;
The AROUSAL (frequency, level, confidence and satisfaction) is HIGH;
The LUBRICATION in terms of frequency, difficulty and frequency in mantaining is in average /with a tendency to lower scores;
The frequency, the difficult and the satisfaction about ORGASM is in average with a tendency to lower scores;
The SATISFACTION is in average
The PAIN in terms of frequency during/following vaginal penetration is generally HIGH;
The Total Score is borderline, close to the risk of sexual dysfunctions
TRANSWOMEN
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AIMS
To compare the quality of sexual life between transwomen and control women
To investigate the sexual functioning in transwomen after SRS
To compare the sexual functioning between transwomen and control women
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*Cut off ≤26,55 risk for sexual dysfunction (Wieger et al., Journal of Sex & Marital Therapy, 31:1-20, 2005)
Sexual functioning : F.S.F.I.
Transwomen Control women
DESI RE 4,3 1,2 AROUSAL 4,4 1,0 LUBRI CATI ON 4,4 1,2 ORGASM 4,4 1,2 SATI SFACTI ON 4,3 1,5 PAI N 3,7 1,6
TOTAL SCORE 25,78 7,7
DESI RE 3,8 1,1 AROUSAL 4,9 0,7 LUBRI CATI ON 5,1 1,2 ORGASM 5,5 1,1 SATI SFACTI ON 4,3 1,4 PAI N 4,5 1,6
TOTAL SCORE 28,10 7,1
Mean
±SD ±SDMean
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The control womens’ DESIRE in terms of frequency and level is LOWER than Transwomen
The AROUSAL is HIGH in both groups
The LUBRICATION and the ORGASM (frequency, level, difficult, confidence and satisfaction) are HIGH in the control group while they are in an average level in the Trans women sample
The SATISFACTION is in an average level in both groups
The control group’s PAIN in terms of frequency during/following vaginal penetration is LOWER than Transwomen
The TOTAL SCORE is in average; normative cluster (i.e no risk of sexual dysfunctions)
CONTROL WOMEN versus TRANSWOMEN
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CONCLUSIONSCONCLUSIONSCONCLUSIONSCONCLUSIONS
1.After SRSthe Quality of Sexual Life is good without statistically
differences fromcontrol women
1.After SRSthe Quality of Sexual Life is good without statistically
differences fromcontrol women
2. Transwomenshowed some difficults in
sexual functioning
2. Transwomenshowed some difficults in
sexual functioning
3. The main problemsare concerning
Lubrication, orgasm and pain
3. The main problemsare concerning
Lubrication, orgasm and pain
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CONCLUSIONSCONCLUSIONSCONCLUSIONSCONCLUSIONS
Problems about lubrication are related to
the kind of surgery(only two patients made
“rectosigmoid flap”)
Problems about lubrication are related to
the kind of surgery(only two patients made
“rectosigmoid flap”)
Problems about orgasm and pain
are probably related to the difficulty in integrating
new genitalia in the
Body Image
Problems about orgasm and pain
are probably related to the difficulty in integrating
new genitalia in the
Body Image
We think that after SRS a specific
psychosexual intervention is necessary
We think that after SRS a specific
psychosexual intervention is necessary